Individual
DR. MATTHEW WILLIAM SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207UN0902X
Nuclear Imaging & Therapy Physician
62883-20
WI
2085P0229X
Pediatric Radiology Physician
Primary
62883-20
WI
2085R0202X
Diagnostic Radiology Physician
036-150688
IL
2085R0202X
Diagnostic Radiology Physician
62883-20
WI
Other
Enumeration date
07/18/2013
Last updated
01/08/2024
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