Individual
STEVEN SHI-TSEN MOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
200200747
NC
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
200200747
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1313P
BCBS
NC
05
—
2005065000
—
WV
05
—
6736998
—
VA
01
—
7930436
AETNA
NC
01
—
800062
PARTNERS
NC
05
—
891313P
—
NC
01
—
B8058
MEDCOST
NC
05
—
Q0074G
—
SC
Enumeration date
12/13/2005
Last updated
04/10/2018
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