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NPI Code Detail

MEDICARE: MRS. CATHY H SHORE MD

MEDICARE: MRS. CATHY H 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
1207QA0505XAdult Medicine Physician30042NC

General Provider Information

NPI Number : 1366437394
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CATHY H SHORE MD
Provider Business Mailing Address
First Line : 3225 COUNTRY CLUB RD
Second Line :
City : YADKINVILLE
State : NC
Zip : 27055-5132
Country : US
Telephone Number : 336-679-7393
Fax Number :
Provider Business Practice Location Address
First Line : 624 W MAIN ST
Second Line :
City : YADKINVILLE
State : NC
Zip : 27055-7804
Country : US
Telephone Number : 336-679-6758
Fax Number : 336-679-6744
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2005
Last Update Date : 07/08/2007

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Directions to “ MRS. CATHY H SHORE MD” Practice Location

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