Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 10005 | MA |
NPI | 1073611869 |
---|---|
Provider Name | Dr. Norman Joseph Shepherd |
First Address | Haverhill, MA 01830 |
Second Address | Haverhill, MA 01830 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |