Individual
PETER SHEPARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1 BOSTON MEDICAL CTR PL, SUITE 5108, BOSTON, MA 02118-2908
(617) 638-7062
Mailing address
1 BOSTON MEDICAL CTR PL, SUITE 5108, BOSTON, MA 02118-2908
(617) 638-7062
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
214719
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0300030
MBHP
MA
05
—
1300881
—
MA
Enumeration date
04/04/2007
Last updated
08/29/2014
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