Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 066068 | GA |
NPI | 1053588731 |
---|---|
Provider Name | Dr. David Douglas Shepard |
First Address | Decatur, GA 30033-6132 |
Second Address | Decatur, GA 30033-6132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2008 |
Last Update Date | 31/10/2018 |