MEDICARE: MYUNG HYO SHIN MD

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	207VG0400X	Gynecology Physician	MD032923L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
11	160032948	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3088	OTHER	PA	BRAVOH EALTH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4101949	OTHER	PA	AETNA PPO
4	P425936	OTHER	PA	OXFORD
5	040414	OTHER	PA	KEYSTONE MERCY HEALTH
6	2Y3371	OTHER	PA	HEALTH NET
7	3303054	OTHER	PA	AETNA HMO
8	176437	OTHER	PA	HIGHMARK BLUE SHIELD
9	0052973000	OTHER	PA	INDEPENDENCE BLUE CROSS
10	0075113301	OTHER	PA	AMERICHOICE
12	519057	OTHER	PA	COVENTRY HEALTH AMERICA

General Provider Information

NPI Number	:	1982688511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYUNG HYO SHIN MD

Provider Business Mailing Address
First Line	:	PO BOX 820933
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19182-0933
Country	:	US
Telephone Number	:	215-926-9010
Fax Number	:	215-226-8285

Provider Business Practice Location Address
First Line	:	2301 E ALLEGHENY AVE
Second Line	:	SUITE 180
City	:	PHILA
State	:	PA
Zip	:	19134-4427
Country	:	US
Telephone Number	:	215-969-3700
Fax Number	:	215-939-3703

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

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	07/19/2011

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Directions to “ MYUNG HYO SHIN MD” Practice Location

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