Provider Demographics
NPI:1750840807
Name:SHIH, SHAWN (MD)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:SHIH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 ORIENT WAY STE 204
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2086
Mailing Address - Country:US
Mailing Address - Phone:201-623-8000
Mailing Address - Fax:201-578-5160
Practice Address - Street 1:75 ORIENT WAY STE 204
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-2086
Practice Address - Country:US
Practice Address - Phone:201-623-8000
Practice Address - Fax:201-578-5160
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322757207N00000X
NJ25MA12677200207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology