Individual
ETHEL CAROLINE SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3150 ROGERS RD STE 101, WAKE FOREST, NC 27587
(919) 504-4000
(984) 235-1250
Mailing address
3150 ROGERS RD STE 101, WAKE FOREST, NC 27587-4196
(919) 504-4000
(984) 235-1250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0010-07550
NC
Other
Enumeration date
01/03/2018
Last updated
02/28/2019
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