Individual
MARC SHEPARD
Active
Individual
MARC SHEPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
12080
DC
207R00000X
Internal Medicine Physician
302575
NY
207R00000X
Internal Medicine Physician
D0026382
MD
207R00000X
Internal Medicine Physician
Primary
MD12080
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
415507S24
MEDICARE INDIV PTAN
DC
Enumeration date
10/12/2006
Last updated
02/03/2021
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