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General NPI Number Information
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NPI Number | 1811365513
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Entity Type | Organization
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Legal Business Name | SARAH D. SHEPHERD, D.O.LLC
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Dates
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Enumeration Date | 09/11/2015
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 27 WADLIN ROAD
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City | BIDDEFORD
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State | ME
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Zip | 04005
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Country | US
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Telephone | 970-201-7887
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Fax | 207-502-7327
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Provider Business Mailing Address
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Address Line | 83 PORTLAND ROAD SUITE #2
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City | KENNEBUNK
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State | ME
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Zip | 04043
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Country | US
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Telephone | 207-502-7281
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Fax | 207-502-7327
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. SARAH DANIELLE SHEPHERD
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Credential | D.O.
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Telephone | 207-502-7281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | DO2307
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License Number State | ME
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