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Individual

DR. SANG O SHIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5180
(265) 171-1505
Mailing address
905 MADISON ST NE, ALBUQUERQUE, NM 87110-6214
(505) 239-9435

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
10564
NV
207P00000X
Emergency Medicine Physician
11099
MT
207P00000X
Emergency Medicine Physician
M-9682
ID
207P00000X
Emergency Medicine Physician
Primary
MD2013-0642
NM

Other

Enumeration date
05/25/2006
Last updated
04/08/2020
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