Provider Demographics
NPI:1124279443
Name:SHIN, JOHN HONG (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HONG
Last Name:SHIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3400 CIVIC CENTER BLVD
Mailing Address - Street 2:15TH FLOOR, SOUTH TOWER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:617-803-7021
Mailing Address - Fax:
Practice Address - Street 1:801 SPRUCE ST.
Practice Address - Street 2:3RD FLOOR - SUITE 302
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5701
Practice Address - Country:US
Practice Address - Phone:617-803-7021
Practice Address - Fax:617-643-4680
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2024-09-16
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Provider Licenses
StateLicense IDTaxonomies
PAMD441515207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery