Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | MD072956L | PA |
N | 2080P0202X | Pediatric Cardiologist | ME97404 | FL |
NPI | 1154391019 |
---|---|
Provider Name | Dr. Shirah Shore |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-1339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 07/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2772191 | (05) | FL |
29227 | (02) | FL |