Organization
KWANG HO SHIN, M.D., PC
Active
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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