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Individual

NICHOLAS SHORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 MEDICAL CENTER DR, MORGANTOWN, WV 26506-1200
(304) 598-4000
Mailing address
1 MEDICAL CENTER DR, MORGANTOWN, WV 26506-1200
(304) 598-4000

Taxonomy

Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
215665-1
NY
2086S0120X
Pediatric Surgery Physician
Primary
25708
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01458240
NY
Enumeration date
09/09/2005
Last updated
04/15/2022
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