Provider Demographics
NPI:1033787759
Name:FEI, SHANGNON (MD)
Entity type:Individual
Prefix:
First Name:SHANGNON
Middle Name:
Last Name:FEI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:660 MASON RIDGE CENTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8512
Mailing Address - Country:US
Mailing Address - Phone:314-448-3791
Mailing Address - Fax:314-996-7658
Practice Address - Street 1:1110 HIGHLANDS PLAZA DR E STE 220
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1351
Practice Address - Country:US
Practice Address - Phone:314-273-0195
Practice Address - Fax:314-273-0190
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-17
Last Update Date:2024-06-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2021021804207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine