Provider Demographics
NPI:1033140785
Name:CHEN, SHIXI (OMD)
Entity Type:Individual
Prefix:MRS
First Name:SHIXI
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4610 SAWMILL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2247
Mailing Address - Country:US
Mailing Address - Phone:614-538-0983
Mailing Address - Fax:614-538-0989
Practice Address - Street 1:4610 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2247
Practice Address - Country:US
Practice Address - Phone:614-538-0983
Practice Address - Fax:614-538-0989
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65. 000004171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH118330OtherNATIONWIDE
OH31-1816317OtherNGS AMERICAN
OH311816317OtherUNICARE
OH311816317-00OtherBWC
OH311816317-0000OtherCIGNA
OH311816317OtherHUMANA
OH23-00545OtherUNITEDHEALTHCARE
OH00070977374OtherAETNA