Provider Demographics
NPI:1265963524
Name:SHI, JAY JIAYI (MD)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:JIAYI
Last Name:SHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JIAYI
Other - Middle Name:
Other - Last Name:SHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1400 JACKSON STREET
Mailing Address - Street 2:BUILDING T SUITE 550
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206
Mailing Address - Country:US
Mailing Address - Phone:303-812-3800
Mailing Address - Fax:303-812-4172
Practice Address - Street 1:1400 JACKSON ST
Practice Address - Street 2:BUILDING T SUITE 550
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206
Practice Address - Country:US
Practice Address - Phone:303-812-3800
Practice Address - Fax:303-812-4172
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0064481207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine