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NPI Code Detail

MEDICARE: DR. JIWON JANE SHIN JUE M.D., M.SC.

MEDICARE: DR. JIWON JANE SHIN JUE M.D., M.SC.
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
1207R00000XInternal Medicine PhysicianMD432968PA

General Provider Information

NPI Number : 1700079217
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JIWON JANE SHIN JUE M.D., M.SC.
Provider Business Mailing Address
First Line : 1345 KAREN LN
Second Line :
City : WAYNE
State : PA
Zip : 19087-2706
Country : US
Telephone Number : 215-713-4344
Fax Number :
Provider Business Practice Location Address
First Line : 1345 KAREN LN
Second Line :
City : WAYNE
State : PA
Zip : 19087-2706
Country : US
Telephone Number : 215-713-4344
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2007
Last Update Date : 08/04/2025

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