Provider Demographics
NPI:1376501841
Name:CHIEN, SHELBY QIAN (MD, PHD)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:QIAN
Last Name:CHIEN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:XIAO-BING
Other - Middle Name:
Other - Last Name:QIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:217 LAURA LN
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-6308
Mailing Address - Country:US
Mailing Address - Phone:479-719-9053
Mailing Address - Fax:
Practice Address - Street 1:1500 S PARK LAKE AVE
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342
Practice Address - Country:US
Practice Address - Phone:219-947-6425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01062776A207L00000X
ARE-2126207L00000X
IL036122447207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR141313001Medicaid
AR5L598B142Medicare ID - Type Unspecified
AR141313001Medicaid