Individual
MICHAEL D SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 EAST THIRD STREET, CHATTANOOGA, TN 37403-2241
(423) 778-8837
(423) 778-9301
Mailing address
PO BOX 11023, CHATTANOOGA, TN 37401-2023
(423) 778-3274
(423) 778-2255
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
48225
TN
207Q00000X
Family Medicine Physician
G459940
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G459940
—
CA
01
—
770560203
BLUE CROSS
CA
01
—
770560203 0005
CIGNA
CA
01
—
ZZZ43971Z
BLUE SHIELD
CA
Enumeration date
01/11/2006
Last updated
03/01/2012
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