Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | DO2307 | ME |
Y | 207P00000X | Emergency Physician | 2307 | ME |
NPI | 1003124348 |
---|---|
Provider Name | Dr. Sarah D. Shepherd |
First Address | Biddeford, ME 04005-9422 |
Second Address | Sanford, ME 04073-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2010 |
Last Update Date | 18/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003124348 | (05) | ME |