Provider Demographics
NPI:1801117684
Name:TING, BRIAN SHENG (DPM)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:SHENG
Last Name:TING
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:840 35TH AVENUE PL STE 102
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-8026
Mailing Address - Country:US
Mailing Address - Phone:309-762-5655
Mailing Address - Fax:309-762-5636
Practice Address - Street 1:840 35TH AVENUE PL
Practice Address - Street 2:SUITE 102
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-8026
Practice Address - Country:US
Practice Address - Phone:309-762-5200
Practice Address - Fax:309-762-5636
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL016-005485213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery