Individual
DR. RICHARD A SHORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
904 HARRISON ST, PRINCETON, WV 24740-3011
(304) 461-7100
(304) 461-7112
Mailing address
PO BOX 457, 200 POCAHONTAS TRAIL, WHITE SULPHUR SPRINGS, WV 24986-0457
(304) 536-5030
(304) 536-5051
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1105
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010109892
—
VA
01
—
1038179
WV WORKERS COMPENSATION
—
01
—
262907
CARELINK
—
05
—
3810001390
—
WV
01
—
4324131
AETNA
—
01
—
5181179
CCN
—
01
—
541839718
C&O
—
01
—
541839718107
BS MOUNTAIN STATE
WV
01
—
P00173397
RAILROAD MEDICARE
WV
Enumeration date
06/13/2005
Last updated
01/09/2025
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