Healthcare Provider Details

I. General information

NPI: 1437872678
Provider Name (Legal Business Name): CLAIRE CATHERINE SHEPPARD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17877 W 14 MILE RD
BEVERLY HILLS MI
48025-3127
US

IV. Provider business mailing address

26211 CENTRAL PARK BLVD STE 201
SOUTHFIELD MI
48076-4158
US

V. Phone/Fax

Practice location:
  • Phone: 248-664-3920
  • Fax: 844-598-9632
Mailing address:
  • Phone: 833-667-3627
  • Fax: 833-972-5509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number56010119391
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: