Individual
ANDREW CARL SHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2906 NW VIVION RD, RIVERSIDE, MO 64150-1502
(816) 599-5050
Mailing address
2906 NW VIVION RD, RIVERSIDE, MO 64150-1502
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2022027327
MO
208000000X
Pediatrics Physician
2022027327
MO
Other
Enumeration date
03/29/2018
Last updated
09/08/2022
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