Individual
MELANIE D. SHORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
106 MORAN DRIVE, BONAIRE, GA 31005
(478) 988-1282
(478) 988-3120
Mailing address
106 MORAN DRIVE, BONAIRE, GA 31005
(478) 988-1282
(478) 988-3120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
053167
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0092100603B OR C
—
GA
05
—
092100603D
—
GA
Enumeration date
05/05/2006
Last updated
05/19/2009
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