Provider Demographics
NPI:1033143003
Name:SHUM, CHI CHING (MD)
Entity Type:Individual
Prefix:DR
First Name:CHI
Middle Name:CHING
Last Name:SHUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 UNITED NATIONS PLZ APT 42A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1756
Mailing Address - Country:US
Mailing Address - Phone:917-664-7418
Mailing Address - Fax:646-585-9194
Practice Address - Street 1:210 E 47TH ST APT 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-2104
Practice Address - Country:US
Practice Address - Phone:212-308-4894
Practice Address - Fax:646-585-9194
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2024-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY206710207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY53N801Medicare ID - Type Unspecified
NYG85301Medicare UPIN