MEDICARE: DR. Y. VICTOR SHIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	35-04-6082-S	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180016877	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	922348	OTHER	OH	EYEMED
3	0801004	OTHER	OH	UNITED HEALTHCARE
4	000000130733	OTHER	OH	ANTHEM BC/BS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	341345260	OTHER	OH	AETNA
7	34134526000	OTHER	OH	BUREAU OF WORKERS COMP
8	102468	OTHER	OH	KAISER
9	112070001	OTHER	OH	ADMINISTAR FEDERAL
10	341345260027	OTHER	OH	CARESOURCE

General Provider Information

NPI Number	:	1487657672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. Y. VICTOR SHIN M.D.

Provider Business Mailing Address
First Line	:	6770 MAYFIELD RD
Second Line	:	STE 338
City	:	MAYFIELD HTS
State	:	OH
Zip	:	44124-2299
Country	:	US
Telephone Number	:	440-442-4330
Fax Number	:	440-442-4695

Provider Business Practice Location Address
First Line	:	6770 MAYFIELD RD
Second Line	:	STE 338
City	:	MAYFIELD HTS
State	:	OH
Zip	:	44124-2299
Country	:	US
Telephone Number	:	440-442-4330
Fax Number	:	440-442-4695

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	04/24/2024

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