Individual
DR. MARYANN CHRISTINE SHEPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC, PA-C,CPT
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 724-6100
Mailing address
1499 WALTON WAY, SUITE 1400, AUGUSTA, GA 30901-2602
(706) 724-6100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7169
GA
363A00000X
Physician Assistant
A453639
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4411-8578
CERTIFIED PHLEBOTOMY TECHNICIAN 1 LICENSE CERTIFICATION BY THE NHA
CA
01
—
7169
GA PA LICENSE
GA
01
—
A453639
LICENSE
CA
01
—
PA18073
PA LICENSE 18073
CA
Enumeration date
12/01/2006
Last updated
01/16/2015
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