Provider Demographics
NPI:1477662088
Name:SHEN, MAOXING (MD)
Entity Type:Individual
Prefix:
First Name:MAOXING
Middle Name:
Last Name:SHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:763-587-9000
Mailing Address - Fax:763-587-9130
Practice Address - Street 1:11475 ROBINSON DR NW
Practice Address - Street 2:MAIL STOP 32600A
Practice Address - City:COON RAPID
Practice Address - State:MN
Practice Address - Zip Code:55433-3746
Practice Address - Country:US
Practice Address - Phone:763-754-4600
Practice Address - Fax:763-754-4614
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN48756207K00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology