Individual
DR. GARY L SHEPHERDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MCW & ALL SAINTS HEALTH CARE SYSTEM, 1320 WISCONSIN AVE., RACINE, WI 53403
(262) 638-5600
Mailing address
1320 WISCONSIN AVE, MCW & ALL SAINTS HEALTH CARE SYSTEM, RACINE, WI 53403-1978
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21190
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30251600
—
WI
Enumeration date
05/17/2006
Last updated
07/08/2007
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