NPI Profile for SHORELINE MEDICAL GROUP PA in PORT SAINT JOE, FL.
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Nephrology |
207RN0300X | 11 | Physician/Internal Medicine | |
Internal Medicine |
207R00000X | 11 | Physician/Internal Medicine | |
Pediatrics |
208000000X | 37 | Physician/Pediatric Medicine | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic |
| NPI # | 1427160571 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 08/31/2006 | |
| Last updated | 12/19/2018 - About 7 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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SHORELINE MEDICAL GROUP, P.A.
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