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NPI Code Detail

MEDICARE: DR. SHIRAH SHORE MD

MEDICARE: DR. SHIRAH SHORE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080P0202XPediatric Cardiology PhysicianMD072956LPA
22080P0202XPediatric Cardiology PhysicianME97404FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154391019
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHIRAH SHORE MD
Provider Business Mailing Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-4903
Country : US
Telephone Number : 570-271-6144
Fax Number :
Provider Business Practice Location Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-1339
Country : US
Telephone Number : 570-271-6089
Fax Number : 570-271-6002
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2006
Last Update Date : 02/09/2026

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