Provider Demographics
NPI:1740397231
Name:LO, SHIH CHIEH (MD)
Entity Type:Individual
Prefix:
First Name:SHIH
Middle Name:CHIEH
Last Name:LO
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 1:161 THOUSAND OAKS DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1842
Mailing Address - Country:US
Mailing Address - Phone:412-466-1203
Mailing Address - Fax:412-469-8988
Practice Address - Street 1:1200 BROOKS LN
Practice Address - Street 2:SUITE 280
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-3747
Practice Address - Country:US
Practice Address - Phone:412-466-1203
Practice Address - Fax:412-469-8988
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032844E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1065251Medicaid
PA1065251Medicaid
C34558Medicare UPIN