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Individual
EMILY ROSE SHORTRIDGE
Active
Individual
EMILY ROSE SHORTRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R73592
AZ
207W00000X
Ophthalmology Physician
39452
SC
207W00000X
Ophthalmology Physician
54569
AZ
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
54569
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R73592
PERMIT
AZ
Enumeration date
06/25/2012
Last updated
06/01/2018
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