Individual
DR. BRADLEY SCOTT SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4901 WILLS ST, METAIRIE, LA 70006-1132
(952) 595-1100
(952) 942-3361
Mailing address
11995 SINGLETREE LN, SUITE 500, EDEN PRAIRIE, MN 55344-5347
(952) 595-1100
(952) 942-3361
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
022372
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102090529
—
PA
05
—
1481823
—
LA
05
—
1948063
—
LA
Enumeration date
06/16/2005
Last updated
05/31/2011
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