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Individual

ANNETTE V SHORES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2 GOOD SAMARITAN WAY, SUITE 235, MOUNT VERNON, IL 62864-2408
(618) 899-3980
(618) 899-4793
Mailing address
2 GOOD SAMARITAN WAY, SUITE 235, MOUNT VERNON, IL 62864-2408
(618) 899-3980
(618) 899-4793

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036093049
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036093049
IL
Enumeration date
06/24/2005
Last updated
01/08/2014
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