Shin, Joong

Shin, Joong is an individual health care provider with primary practice located at 822 Kumho Dr Suite 202, Fairlawn OH 44333-9297. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Shin, Joong can be contacted via phone (330) 576-0500.

Contact Information

Primary practice address
822 Kumho Dr Suite 202 Fairlawn OH 44333-9297
Phone: (330) 576-0500
Fax: (330) 576-0467
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35067515S Ohio
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 35080113 Ohio

Profile Details

NPI number 1053347054
LBN Legal business name Shin, Joong
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Apr 7th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053347054 NPPES
Ohio Other 341906264028 CARESOURSE
Ohio Other 729245 CARESOURSE
Ohio Other 000000141920 CARESOURSE
Ohio Other 0005691637 CARESOURSE
Ohio MEDICAID 2008384 CARESOURSE

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