Doctor Name: | CLAY DANIEL SHORTER |
NPI Number: | 1013233261 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA |
License Number: | 0110003276 |
Business Practice Address: | 2405 Atherholt Rd Lynchburg, VA - 245012184 |
Business Phone Number: | 4344858500 |
Business Fax Number: | 4344858599 |
Mailing Address: | 2405 Atherholt Rd, LYNCHBURG |
State: | VA |
Postal Code: | 245012184 |
Phone Number: | 4344858500 |
Fax Number: | 4344858599 |
NPI Enumeration Date: | 04/13/2010 |
NPI Last Update Date: | 05/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 0110003276 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |