Provider Demographics
NPI:1275722944
Name:LING T SHIH MD PC
Entity Type:Organization
Organization Name:LING T SHIH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LING
Authorized Official - Middle Name:T
Authorized Official - Last Name:SHIH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-631-6125
Mailing Address - Street 1:4007 ORCHARD DR
Mailing Address - Street 2:STE 2005
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6102
Mailing Address - Country:US
Mailing Address - Phone:989-631-6125
Mailing Address - Fax:
Practice Address - Street 1:4007 ORCHARD DR
Practice Address - Street 2:STE 2005
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6187
Practice Address - Country:US
Practice Address - Phone:989-631-6125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILS031767207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI10/1065000Medicaid
MI0N90050Medicare PIN
MI10/1065000Medicaid