Organization
KWANG HO SHIN, M.D., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KWANG HO SHIN M.D. (PRESIDENT)
(716) 634-4798
Entity
Organization
Contact information
Practice address
338 HARRIS HILL RD, SUITE 207, WILLIAMSVILLE, NY 14221-7407
(716) 634-4798
(716) 634-0987
Mailing address
338 HARRIS HILL RD, SUITE 207, WILLIAMSVILLE, NY 14221-7407
(716) 634-4798
(716) 634-0987
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
128135-0
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000507416001
BLUE CROSS
NY
05
—
00617354
—
NY
01
—
2009728
INDEPENDENT HEALTH
NY
Enumeration date
09/26/2006
Last updated
08/22/2020
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