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Individual

EON K SHIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
834 CHESTNUT ST, SUITE G114, PHILADELPHIA, PA 19107-5127
(215) 521-3000
(215) 521-3002
Mailing address
834 CHESTNUT ST, SUITE G114, PHILADELPHIA, PA 19107-5127
(215) 521-3000
(215) 521-3002

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
227333
MA
207X00000X
Orthopaedic Surgery Physician
25MA08306100
NJ
207X00000X
Orthopaedic Surgery Physician
MD431878
PA
207XS0106X
Orthopaedic Hand Surgery Physician
25MA08306100
NJ
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
MD431878
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2010587
PBS
PA
01
3318492000
INDEPENDENCE BLUE CROSS/KEYSTONE
PA
01
P00621736
RR MEDICARE
PA
Enumeration date
06/29/2006
Last updated
02/09/2010
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