Provider Demographics
NPI:1043455595
Name:SHEN, YANG (MD)
Entity type:Individual
Prefix:MS
First Name:YANG
Middle Name:
Last Name:SHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:SHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5720 BLAZER PKWY
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-3566
Mailing Address - Country:US
Mailing Address - Phone:614-761-1151
Mailing Address - Fax:614-761-1313
Practice Address - Street 1:5720 BLAZER PKWY
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-3566
Practice Address - Country:US
Practice Address - Phone:614-761-1151
Practice Address - Fax:614-761-1313
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207N00000X207N00000X
OH35.093940207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology