Healthcare Provider Details

I. General information

NPI: 1629079843
Provider Name (Legal Business Name): ALFRED LEWIS SHEARER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3719 DAUPHIN ST SUITE 102
MOBILE AL
36608-1753
US

IV. Provider business mailing address

3719 DAUPHIN ST SUITE 102
MOBILE AL
36608-1753
US

V. Phone/Fax

Practice location:
  • Phone: 251-344-1502
  • Fax: 251-342-1116
Mailing address:
  • Phone: 251-344-1502
  • Fax: 251-342-1116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number15420
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: