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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
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