Individual
PETER M. SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3917 WEST RD, STE 200, LOS ALAMOS, NM 87544-5301
(505) 661-4147
Mailing address
1620 N MAIN ST, SPANISH FORK, UT 84660-1008
(801) 822-2234
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
MD2009-0111
NM
Other
Enumeration date
06/14/2006
Last updated
12/16/2020
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