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General NPI Number Information
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NPI Number | 1194001503
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Entity Type | Individual
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Provider Name | YAN SHI M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/30/2011
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 11100 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone | 168-443-0152
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Fax |
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Provider Business Mailing Address
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Address Line | 1 BAYLOR PLZ SUITE 404D
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City | HOUSTON
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State | TX
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Zip | 77030-3411
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Country | US
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Telephone |
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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 | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | 35.140369
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License Number State | OH
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