Basic Information
| Provider Information | |||||||||
| NPI: | 1508983362 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SHORE HOSPITALISTS ASSOCIATES P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7651 WOODLAND DR | ||||||||
| Address2: | |||||||||
| City: | EASTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216018141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103106245 | ||||||||
| FaxNumber: | 4108229683 | ||||||||
| Practice Location | |||||||||
| Address1: | 219 S WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | EASTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216012913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103106245 | ||||||||
| FaxNumber: | 4108229685 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2007 | ||||||||
| LastUpdateDate: | 09/04/2009 | ||||||||
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| AuthorizedOfficialLastName: | DE SHIELDS | ||||||||
| AuthorizedOfficialFirstName: | DENNIS | ||||||||
| AuthorizedOfficialMiddleName: | MICHAEL | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4103106245 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.