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General NPI Number Information
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NPI Number | 1245333855
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Entity Type | Organization
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Legal Business Name | RHEUMATOLOGY ASSOCIATES PC
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 12/21/2007
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Provider Practice Location Address
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Address Line | 1841 NEWMAN ROAD
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City | OKEMOS
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State | MI
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Zip | 48864
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Country | US
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Telephone | 517-349-7620
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Fax | 517-349-7086
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Provider Business Mailing Address
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Address Line | 1841 NEWMAN ROAD
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City | OKEMOS
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State | MI
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Zip | 48864
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Country | US
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Telephone | 517-349-7620
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Fax | 517-349-7086
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Authorized Official
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Title or Position | OWNER PRACTITIONER
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Name | DR. ROBERT C. SHEPARD
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Credential | MD
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Telephone | 517-349-7620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 030866
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License Number State | MI
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