Individual
BENJAMIN SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
765 LIBERTY ST STE 101, MEADVILLE, PA 16335-2566
(814) 373-3434
(814) 373-2152
Mailing address
1034 GROVE ST, MEADVILLE, PA 16335-2945
(814) 373-3434
(814) 373-2152
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD476511
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/05/2017
Last updated
05/06/2025
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