Provider Demographics
NPI:1639367824
Name:SHEN, MIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MIAN
Middle Name:
Last Name:SHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10704 GLOXINIA DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3404
Mailing Address - Country:US
Mailing Address - Phone:240-463-4848
Mailing Address - Fax:
Practice Address - Street 1:DEPT OF ANESTHEISA & SURGICAL SERVICES NIH/CC
Practice Address - Street 2:BLDG 10/RM 2C624
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-402-3807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD65803207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology