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General NPI Number Information
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NPI Number | 1861704926
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Entity Type | Organization
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Legal Business Name | DR. PHILLIP Y SHOU PC
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 2801 BOULEVARD SUITE D
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2323
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Country | US
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Telephone | 804-526-3821
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Fax | 804-526-6065
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Provider Business Mailing Address
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Address Line | 2801 BOULEVARD SUITE D
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2323
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Country | US
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Telephone | 804-526-3821
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Fax | 804-526-6065
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Authorized Official
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Title or Position | OFFICER
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Name | DR. PHILLIP Y SHOU
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Credential | M.D
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Telephone | 804-526-3821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101041517
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101041517
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License Number State | VA
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