# ALEXANDER D. SHEPARD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1114080744
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 048953 | MI | Yes |

## Other

- **Enumeration date:** 12/18/2006
- **Last updated:** 02/27/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 167825210 | — | MI |
| 01 | — | 700H262310 | BLUE CROSS-BLUE CROSS | — |
| 01 | — | AS048953 | COMMERCIAL-COMMERCIAL NUMBER | — |