Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | A87661 | CA |
Y | 2084N0400X | Neurologist | 87902 | MN |
NPI | 1124044334 |
---|---|
Provider Name | Dr. Zhiyi Sha |
First Address | Minneapolis, MN 55455 |
Second Address | Minneapolis, MN 55455 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 12/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A876610 | MEDICAL PPIN # (01) | CA |
984662100 | (05) | MN |
I00935 | (02) | CA |