Healthcare Provider Details

I. General information

NPI: 1760911002
Provider Name (Legal Business Name): ZACHARY SHEPARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2017
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 S AIKEN AVE STE 201
PITTSBURGH PA
15232-1521
US

IV. Provider business mailing address

SHADYSIDE VLG STE 600
PITTSBURGH PA
15206-4028
US

V. Phone/Fax

Practice location:
  • Phone: 412-681-0966
  • Fax:
Mailing address:
  • Phone: 412-681-0966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4301112135
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberT6038
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR.0067412
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: