Individual
CHUNGJA C SHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
406 W OAK STREET, TITUSVILLE AREA HOSPITAL, TITUSVILLE, PA 16354
(814) 827-1851
(814) 827-7259
Mailing address
PO BOX 28, WASHINGTON, PA 15301
(724) 228-3400
(724) 228-7040
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD02206SE
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009579700001
—
PA
Enumeration date
08/30/2006
Last updated
07/08/2007
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