Provider Demographics
NPI:1700830908
Name:SHEN, CYNTHIA SHIN-YI (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:SHIN-YI
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 1:300 BYRN ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-1908
Mailing Address - Country:US
Mailing Address - Phone:410-228-5511
Mailing Address - Fax:410-228-1061
Practice Address - Street 1:300 BYRN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-1908
Practice Address - Country:US
Practice Address - Phone:410-228-5511
Practice Address - Fax:410-228-1061
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0062554207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000039455Medicaid
MD406888201Medicaid
DEH90089OtherBLUE SHIELD
DEH90089OtherBLUE SHIELD
DEH90089OtherBLUE SHIELD
MD406888201Medicaid
DE019058D18Medicare PIN
BS8138895OtherDEA