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General NPI Number Information
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NPI Number | 1124279443
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Entity Type | Individual
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Provider Name | JOHN HONG SHIN MD
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Gender | Male
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 801 SPRUCE ST. 3RD FLOOR - SUITE 302
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5701
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Country | US
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Telephone | 617-803-7021
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Fax | 617-643-4680
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Provider Business Mailing Address
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Address Line | 3400 CIVIC CENTER BLVD 15TH FLOOR, SOUTH TOWER
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City | PHILADELPHIA
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State | PA
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Zip | 19104
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Country | US
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Telephone | 617-803-7021
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | MD441515
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License Number State | PA
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