Individual
AILSA CATRIONA SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2211 CONGRESS ST, PORTLAND, ME 04122-0002
(207) 575-2682
Mailing address
2211 CONGRESS ST, PORTLAND, ME 04122-0002
(207) 575-2682
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD16492
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407040099
—
ME
Enumeration date
06/13/2006
Last updated
04/21/2015
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