# MICHAEL YUZHOU SHAO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1508196122
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | 036117153 | IL | — |
| 2086S0129X | Vascular Surgery Physician | 01092661A | IN | Yes |
| 2086S0129X | Vascular Surgery Physician | 036117153 | IL | — |

## Other

- **Enumeration date:** 01/04/2010
- **Last updated:** 03/03/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 036117153 | — | IL |
| 01 | — | 406120 | MEDICARE PTAN FOR SCMG | IL |
| 01 | — | 406120075 | MEDICARE INDIVIDUAL PTAN | IL |