Basic Information
| Provider Information | |||||||||
| NPI: | 1477847846 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHEN | ||||||||
| FirstName: | JANE | ||||||||
| MiddleName: | MEEYOUNG LEE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1501 S CLINTON ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212245730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105229940 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1501 S CLINTON ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212245730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105229940 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2011 | ||||||||
| LastUpdateDate: | 12/14/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D78167 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.