Organization
SHINE MEDICAL PROVIDERS PC
Active
Organization
SHINE MEDICAL PROVIDERS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARE FRANCES BOALS FRYE (SVP OF OPERATIONS)
(616) 648-1196
Entity
Organization
Contact information
Practice address
709 N 2ND ST STE 400, PHILADELPHIA, PA 19123-3108
(888) 380-2028
Mailing address
PO BOX 360721, PITTSBURGH, PA 15251-6721
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
07/19/2022
Last updated
10/04/2024
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