Individual
DR. BENJAMIN JOEL SHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 LONGWOOD AVE, DEPARTMENT OF ORTHOPEDIC SURGERY - HUNNEWELL 221, BOSTON, MA 02115-5724
(617) 355-6808
(617) 730-0465
Mailing address
300 LONGWOOD AVE, DEPARTMENT OF ORTHOPEDIC SURGERY - HUNNEWELL 221, BOSTON, MA 02115-5724
(617) 355-6808
(617) 730-0465
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
243828
MA
207X00000X
Orthopaedic Surgery Physician
MD24223
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
239359
CERTIFICATE OF LIMITED REGISTRATION
MA
01
—
243828
MASS LICENCE
MA
Enumeration date
03/01/2010
Last updated
02/09/2021
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