Provider Demographics
NPI:1750397121
Name:SHIM, ZAE U (MD)
Entity type:Individual
Prefix:MR
First Name:ZAE
Middle Name:U
Last Name:SHIM
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 1:1000 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-2527
Mailing Address - Country:US
Mailing Address - Phone:856-327-0016
Mailing Address - Fax:856-327-5264
Practice Address - Street 1:1000 N HIGH ST
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-2527
Practice Address - Country:US
Practice Address - Phone:856-327-0016
Practice Address - Fax:856-327-5264
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02623000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ29222177BMedicaid
NJ29222177BMedicaid