Provider Demographics
NPI:1114007820
Name:YIU, SHIH SHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIH SHEN
Middle Name:
Last Name:YIU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:YIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-282-5000
Mailing Address - Fax:
Practice Address - Street 1:9300 NOBLE PKWY N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-5500
Practice Address - Country:US
Practice Address - Phone:763-236-5300
Practice Address - Fax:763-236-5250
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MN51829207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN080020781Medicare PIN