Individual
EDWARD Q SHEPHERD
Active
Individual
EDWARD Q SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
184699-1205
UT
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
184699-1205
UT
2085R0202X
Diagnostic Radiology Physician
11114
NV
2085R0202X
Diagnostic Radiology Physician
Primary
184699-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107005493101
IHC#
UT
01
—
87048757000001
BX
UT
05
—
870487570004
—
UT
01
—
870487570SH1
EMIA
UT
01
—
907767
DMBA
UT
Enumeration date
05/12/2006
Last updated
08/01/2011
Update your record
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