Individual
JOONG SHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
822 KUMHO DR, SUITE 202, FAIRLAWN, OH 44333-9297
(330) 576-0500
(330) 576-0467
Mailing address
822 KUMHO DR, SUITE 202, FAIRLAWN, OH 44333-9297
(330) 576-0500
(330) 576-0467
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35067515S
OH
208M00000X
Hospitalist Physician
35080113
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000141920
ANTHEM
OH
01
—
0005691637
AETNA
OH
05
—
2008384
—
OH
01
—
341906264028
CARESOURSE
OH
01
—
729245
BUCKEYE COMMUNITY HEALTH
OH
Enumeration date
06/23/2006
Last updated
04/07/2009
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