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Individual

DR. PHILIP SHORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1210 ASHLAND AVE, ZANESVILLE, OH 43701-2806
(740) 454-8551
(740) 454-2411
Mailing address
860 BETHESDA DR, ZANESVILLE, OH 43701-1800
(740) 454-4651
(740) 454-4653

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35054962S
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000019195
ANTHEM PIN
OH
01
000000177547
UNISON PIN
OH
01
0493361
UHC PIN
OH
05
0665089
OH
01
0989499
GROUP MEDICAID
OH
01
CA1586
GROUP MEDICARE RAILROAD
Enumeration date
12/21/2005
Last updated
04/01/2008
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