Individual
DR. CHANJUAN SHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
1161 21ST AVE S, C3321A MCN, NASHVILLE, TN 37232-2561
(615) 936-8342
Mailing address
1161 21ST AVE S, C3321A MCN, NASHVILLE, TN 37232-2561
(615) 936-8342
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD0000046051
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I228107
TENNESSEE MEDICARE NUMBER
—
05
—
1519600
—
TN
Enumeration date
01/17/2007
Last updated
09/06/2012
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