Individual
DR. ELIAN MICHAEL SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9235 BROADWAY, MERRILLVILLE, IN 46410-7046
(219) 738-2255
(219) 738-2060
Mailing address
101 E 87TH AVE, MERRILLVILLE, IN 46410-7335
(219) 738-2255
(219) 738-2060
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01033705A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000086878
ANTHEM
IN
05
—
100195070A
—
IN
01
—
200020693
RR MEDICARE PIN
IN
Enumeration date
02/21/2007
Last updated
03/08/2016
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