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Individual

LARRY MASON SHEPHERD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
801 EASTWIND DR, WESTERVILLE, OH 43081-3303
(614) 882-9460
(614) 882-9802
Mailing address
801 EASTWIND DR, WESTERVILLE, OH 43081-3303
(614) 882-9460
(614) 882-9802

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35.051445
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0576765
OH
Enumeration date
07/05/2006
Last updated
04/21/2015
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