MEDICARE: DR. NEIL S. 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
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	29592	MA
2	207RP1001X	Pulmonary Disease Physician	29592	MA
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	29592	MA

Other Identifiers

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

General Provider Information

NPI Number	:	1346243698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL S. SHORE MD

Provider Business Mailing Address
First Line	:	55 HIGHLAND AVE
Second Line	:	STE 104
City	:	SALEM
State	:	MA
Zip	:	01970-2100
Country	:	US
Telephone Number	:	978-745-4489
Fax Number	:	978-354-2085

Provider Business Practice Location Address
First Line	:	55 HIGHLAND AVE
Second Line	:	STE 104
City	:	SALEM
State	:	MA
Zip	:	01970-2100
Country	:	US
Telephone Number	:	978-745-4489
Fax Number	:	978-354-2085

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	09/11/2025

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Directions to “ DR. NEIL S. SHORE MD” Practice Location

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