Individual
MICHAEL SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4150
Mailing address
3000 HOSPITAL DR, BATAVIA, OH 45103-1921
(513) 732-8200
(937) 619-4150
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
COA.15057-NP
OH
Other
Enumeration date
08/29/2013
Last updated
08/29/2013
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