Robert Shore, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD028196E Issued in PA

Practice address

7602 Central Ave
Stapeley BLDG Suite 101
Phila, PA 19111-2443

Phone

(215) 969-2900

Fax

(215) 969-1856

NPI assigned

Aug 17, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1013020304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7602 CENTRAL AVE",
            "address_2": "STAPELEY BLDG SUITE 101",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191112443",
            "telephone_number": "215-969-2900",
            "fax_number": "215-969-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7602 CENTRAL AVE",
            "address_2": "STAPELEY BLDG SUITE 101",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191112443",
            "telephone_number": "215-969-2900",
            "fax_number": "215-969-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD028196E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "0045926000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "497647",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009477950001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Nicole Shepard, PA-C
• Nelson N Shih, DDS
• Joshua Shin
• Myung Hyo Shin, MD
• Steven Shipon, D.D.S.
• Zarrin Shouraie, MD
• Arpita Shrivastava, MD
• Claudia S. Sieber, RN
• Eugene Herbert Siegel, D.O.
• Wydia Tamika Simmons

• Internal Medicine Physician in Phila, PA
• Providers in Phila, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.