Shor, Samuel Mark

Shor, Samuel Mark is an sole proprietor health care provider with primary practice located at 1860 Town Center Dr Suite 230, Reston VA 20190-5896. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Shor, Samuel Mark can be contacted via phone (703) 709-1119.

Contact Information

Primary practice address
1860 Town Center Dr Suite 230 Reston VA 20190-5896
Phone: (703) 709-1119
Fax: (703) 709-7496
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 101036333 Virginia

Profile Details

NPI number 1184611964
LBN Legal business name Shor, Samuel Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 5th, 2005
Last updated Jan 5th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184611964 NPPES
Virginia Other 504468 NCPPO PROVIDER NUMBER
Virginia Other 745990 NCPPO PROVIDER NUMBER

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