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NPI Code Detail

MEDICARE: GONGLIANG SHUE M.D.

MEDICARE: GONGLIANG SHUE 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
1207L00000XAnesthesiology PhysicianMD-066872-LPA

General Provider Information

NPI Number : 1861475477
Entity Type Code : Individual
Provider Name (Legal Business Name) : GONGLIANG SHUE M.D.
Provider Business Mailing Address
First Line : 195 STARDUST DR
Second Line :
City : JOHNSTOWN
State : PA
Zip : 15904-3064
Country : US
Telephone Number : 814-262-9276
Fax Number :
Provider Business Practice Location Address
First Line : 600 SOMERSET AVE
Second Line :
City : WINDBER
State : PA
Zip : 15963-1331
Country : US
Telephone Number : 814-467-3450
Fax Number : 814-467-3412
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 07/08/2007

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Directions to “ GONGLIANG SHUE M.D.” Practice Location

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