Individual
XIAOMING SHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(208) 467-7608
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101257822
VA
208600000X
Surgery Physician
Primary
1171744
ID
Other
Enumeration date
05/07/2013
Last updated
05/22/2025
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