Provider Demographics
NPI:1699741041
Name:LI, SHOUPING (MD)
Entity type:Individual
Prefix:
First Name:SHOUPING
Middle Name:
Last Name:LI
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 1:10282 VIA COMO
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-4324
Mailing Address - Country:US
Mailing Address - Phone:775-304-8748
Mailing Address - Fax:
Practice Address - Street 1:50 E HASKELL ST STE A
Practice Address - Street 2:
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445-3576
Practice Address - Country:US
Practice Address - Phone:775-304-8748
Practice Address - Fax:775-625-8580
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36387207P00000X
NV12382207RC0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease