MEDICARE: EUGENE C SHIEH 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	2085R0001X	Radiation Oncology Physician	ME96250	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P01627956	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P939353	OTHER	FL	OPTIMUM
2	P998277	OTHER	FL	FREEDOM
3	78538	OTHER	FL	BCBS
5	11580	OTHER	FL	DIMENSION HEALTH PPO
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	332414	OTHER	FL	AVMED
8	7830888	OTHER	FL	AETNA

General Provider Information

NPI Number	:	1518057629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUGENE C SHIEH M.D.

Provider Business Mailing Address
First Line	:	2234 COLONIAL BLVD
Second Line	:	ATTN: PAYER CONTRACTING & RELATIONS DEPT.
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1412
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	3343 STATE ROAD 7
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33449-8002
Country	:	US
Telephone Number	:	561-795-9845
Fax Number	:	561-795-8791

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

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	05/19/2016

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Directions to “ EUGENE C SHIEH M.D.” Practice Location

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