Healthcare Provider Details

I. General information

NPI: 1487581781
Provider Name (Legal Business Name): PATRICK SHEPARD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W SUMMIT ST
ANN ARBOR MI
48103-3247
US

IV. Provider business mailing address

111 W SUMMIT ST
ANN ARBOR MI
48103-3247
US

V. Phone/Fax

Practice location:
  • Phone: 734-644-8582
  • Fax:
Mailing address:
  • Phone: 734-644-8582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: