Individual
EMILY L SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3049
(207) 822-2584
Mailing address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3049
(207) 822-2584
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1153
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
434017099
—
CT
05
—
434017099
—
ME
01
—
P00694058
RAILROAD MEDICARE
ME
Enumeration date
03/10/2008
Last updated
05/15/2013
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