Shore, Richard B

Shore, Richard B is an individual health care provider with primary practice located at 2401 W University Ave , Muncie IN 47303-3428. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Shore, Richard B can be contacted via phone (765) 751-1720.

Contact Information

Primary practice address
2401 W University Ave Muncie IN 47303-3428
Phone: (765) 751-1720
Fax: (765) 741-2961
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10002567A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 10002567A Indiana

Profile Details

NPI number 1972086437
LBN Legal business name Shore, Richard B
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 11th, 2018
Last updated Jul 9th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972086437 NPPES
Indiana Other 000001209830 ANTHEM PTAN
Indiana MEDICAID 300018762 ANTHEM PTAN
Indiana Other P02264852 ANTHEM PTAN
Indiana Other 264430789 ANTHEM PTAN

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