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Individual

ANDREW R SHORS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
60 FOUR MILE DRIVE STE 11, KALISPELL, MT 59901-2663
(406) 314-4788
Mailing address
40 FOUR MILE DRIVE, STE 7, KALISPELL, MT 59901-2655
(406) 314-4788

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
49148
MT
207ND0101X
MOHS-Micrographic Surgery Physician
49148
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
194630
INTERNAL ID-MOTOR VEHICLE ID
05
8387995
WA
Enumeration date
10/16/2006
Last updated
09/28/2020
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