Brian Neal Shore in Champaign - Physician Assistant
Brian Neal Shore - NPI 1376544585
Brian Neal Shore is a Physician Assistant in Champaign, Illinois. Brian Neal Shore practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Brian Neal Shore is 1376544585. The last update date is 2015-03-17.
Brian Neal Shore's current location address is 101 W University Ave, Champaign, Illinois. You can contact this provider via phone number 2173668107. The mailing address for Brian Neal Shore is 101 W University Ave, Champaign, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brian Neal Shore |
|---|---|
| Address | 101 W University Ave, Champaign, Illinois |
| Phone Number | 2173668107 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA C |
NPI Number Detail
| NPI Number | 1376544585 |
|---|---|
| Provider Enumeration Date | 2005-08-10 |
| Last Updated Date | 2015-03-17 |
Provider Mailing Address Detail
| Address | 101 W University Ave |
|---|---|
| City | Champaign |
| State | Illinois (IL) |
| Post Code | 618203909 |
| Phone Number | 2173668107 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 85002428 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 434110 | IL | MEDICARE GROUP | |
| P00382778 | IL | RAILROAD MEDICARE |
Post Comment/ Review Below
What is the unique identifier code issued to Brian Neal Shore by the Centers for Medicare & Medicaid Services (CMS)?
The Brian Neal Shore has been assigned the NPI (National Provider Identifier) 1376544585. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical address where Brian Neal Shore is geographically located?
The Brian Neal Shore is physically situated at the following location: 101 W University Ave, Champaign, IL, 618203909.
What is Brian Neal Shore's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Brian Neal Shore's specialized field of practice is Physician Assistant, and the corresponding taxonomy code that categorizes this area of specialization is 363A00000X.
When did the Brian Neal Shore receive its 1376544585?
The Brian Neal Shore was issued its 1376544585 on 2005-08-10, which is the date when the organization was assigned this unique identifier.
As of what date was the information pertaining to Brian Neal Shore, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Brian Neal Shore, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2015-03-17.