Individual
SHANTA SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D,
Contact information
Practice address
19 WOODLAND ST STE 23, HARTFORD, CT 06105-2368
(860) 522-2251
Mailing address
88 E NEWTON ST, C515, BOSTON, MA 02118-2308
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
68747
CT
Other
Enumeration date
04/01/2016
Last updated
05/12/2022
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