Provider Demographics
NPI:1740668078
Name:SHU, LI HUA (LICENSE ACUPUNCTURIS)
Entity type:Individual
Prefix:
First Name:LI HUA
Middle Name:
Last Name:SHU
Suffix:
Gender:M
Credentials:LICENSE ACUPUNCTURIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 ROSWELL RD STE 37
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-8829
Mailing Address - Country:US
Mailing Address - Phone:678-560-7978
Mailing Address - Fax:
Practice Address - Street 1:3535 ROSWELL RD STE 37
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-8829
Practice Address - Country:US
Practice Address - Phone:678-560-7978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA079171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA079OtherACUPUNCTURIST