Provider Demographics
NPI:1124111075
Name:SHIH-CHIEH LO , MD
Entity type:Organization
Organization Name:SHIH-CHIEH LO , MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHIH
Authorized Official - Middle Name:CHIEH
Authorized Official - Last Name:LO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-466-1203
Mailing Address - Street 1:1200 BROOKS LANE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:CLAIRTON
Mailing Address - State:PA
Mailing Address - Zip Code:15025
Mailing Address - Country:US
Mailing Address - Phone:412-466-1203
Mailing Address - Fax:
Practice Address - Street 1:1200 BROOKS LANE
Practice Address - Street 2:SUITE 280
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025
Practice Address - Country:US
Practice Address - Phone:412-466-1203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA032844-E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1065251Medicaid
PA477912Medicare ID - Type Unspecified
PA1065251Medicaid