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General NPI Number Information
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NPI Number | 1770587172
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Entity Type | Individual
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Provider Name | RICHARD A SHORTER DO
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Gender | Male
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Dates
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Enumeration Date | 06/13/2005
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 904 HARRISON ST
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City | PRINCETON
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State | WV
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Zip | 24740-3011
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Country | US
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Telephone | 304-461-7100
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Fax | 304-461-7112
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Provider Business Mailing Address
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Address Line | PO BOX 457 200 POCAHONTAS TRAIL
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City | WHITE SULPHUR SPRINGS
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State | WV
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Zip | 24986-0457
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Country | US
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Telephone | 304-536-5030
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Fax | 304-536-5051
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1105
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License Number State | WV
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