Organization
RONALD SHORE MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID M FISH (VP BILLING)
(410) 872-9188
Entity
Organization
Contact information
Practice address
4701 RANDOLPH RD STE 207, ROCKVILLE, MD 20852-2261
(410) 872-9188
(410) 872-9169
Mailing address
4701 RANDOLPH RD STE 207, ROCKVILLE, MD 20852-2261
(410) 872-9188
(410) 872-9169
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070015957
MEDICARE RAIL ROAD
MD
01
—
6792
BCBS
DC
01
—
8216RN
BCBS
MD
Enumeration date
10/30/2007
Last updated
04/15/2015
Update your record
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