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NPI Code Detail

MEDICARE: GERMAYNE SHEPHERD

MEDICARE:   GERMAYNE  SHEPHERD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1457047607
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERMAYNE SHEPHERD
Provider Business Mailing Address
First Line : 1237 E 172ND ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44119-3128
Country : US
Telephone Number : 216-526-9864
Fax Number :
Provider Business Practice Location Address
First Line : 1237 E 172ND ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44119-3128
Country : US
Telephone Number : 216-526-9864
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2023
Last Update Date : 04/29/2025

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Directions to “ GERMAYNE SHEPHERD ” Practice Location

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