Provider Demographics
NPI:1669681938
Name:CHOU, SHWEE-TIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHWEE-TIAN
Middle Name:
Last Name:CHOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01109-1230
Mailing Address - Country:US
Mailing Address - Phone:413-783-5355
Mailing Address - Fax:413-783-0629
Practice Address - Street 1:517 BOSTON RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-1230
Practice Address - Country:US
Practice Address - Phone:413-783-5355
Practice Address - Fax:413-783-0629
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52228208D00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Not Answered208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6191908Medicaid
MAJ04366Medicare ID - Type Unspecified
MAB97818Medicare UPIN