Individual
DR. BENJAMIN JOEL SHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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