Individual
DR. ERIC EUGENE SHORE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3939 CONSHOHOCKEN AVE, PHILADELPHIA, PA 19131-5400
(215) 877-7400
(215) 877-7479
Mailing address
19 W DARTMOUTH RD, BALA CYNWYD, PA 19004-2520
(610) 664-4182
(610) 664-4372
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS-003157-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0830344
—
PA
Enumeration date
06/24/2005
Last updated
07/08/2007
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