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Individual

KATHLEEN A SHORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
2400 TUCKER NE, ALBUQUERQUE, NM 87131-0001
(505) 272-1734
(505) 272-6308
Mailing address
933 BRADBURY DR SE STE 2222, ALBUQUERQUE, NM 87106-4375
(505) 272-3120
(505) 272-8060

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A12544
CA
207Q00000X
Family Medicine Physician
A156710
NM
390200000X
Student in an Organized Health Care Education/Training Program
R1020
AZ

Other

Enumeration date
06/25/2008
Last updated
07/18/2023
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