Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 10243 | TN |
NPI | 1134142987 |
---|---|
Provider Name | Dr. Robert Allen Shearer |
First Address | Vestavia, AL 35242-2584 |
Second Address | Springfield, TN 37172-2951 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 05/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10075202 | AMERIGROUP (01) | TN |
3118516 | BLUE CROSS/BLUE SHIELD (01) | TN |
3180202 | (05) | TN |
BO3891 | (02) | TN |
TN0101 | AMERICHOICE (01) | TN |