Provider Demographics
NPI:1245020007
Name:SHA, CONGZHOU (PHD)
Entity type:Individual
Prefix:DR
First Name:CONGZHOU
Middle Name:
Last Name:SHA
Suffix:
Gender:
Credentials:PHD
Other - Prefix:DR
Other - First Name:CONGZHOU
Other - Middle Name:MIKE
Other - Last Name:SHA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:2113 RED FOX DR
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-7090
Mailing Address - Country:US
Mailing Address - Phone:610-905-0794
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:800-243-1455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program