Individual
ROBERT W SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
807 W MAIN ST, WILMINGTON, OH 45177-0868
(937) 382-1864
(937) 382-8917
Mailing address
PO BOX 868, 807 W MAIN ST, WILMINGTON, OH 45177-0868
(937) 382-1864
(937) 382-8917
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
023286
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000012261
ANTHEM
OH
05
—
0539626
—
OH
Enumeration date
02/08/2007
Last updated
03/17/2008
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