Provider Demographics
NPI:1013987551
Name:SHORT, HOWARD NEWTON (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:NEWTON
Last Name:SHORT
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Gender:M
Credentials:MD, FACS
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Mailing Address - Street 1:1351 JEFFERSON ST
Mailing Address - Street 2:STE 110
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-6449
Mailing Address - Country:US
Mailing Address - Phone:636-239-1650
Mailing Address - Fax:636-239-9005
Practice Address - Street 1:1351 JEFFERSON ST
Practice Address - Street 2:STE 110
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-6449
Practice Address - Country:US
Practice Address - Phone:636-239-1650
Practice Address - Fax:636-239-9005
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MOR9366207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOB18443Medicare UPIN