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NPI Code Detail

MEDICARE: MR. SHEPPARD ALLEN MCKENZIE III MD

MEDICARE: MR. SHEPPARD ALLEN MCKENZIE III MD
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
1207VX0000XObstetrics Physician19373NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609878297
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SHEPPARD ALLEN MCKENZIE III MD
Provider Business Mailing Address
First Line : 3805 COMPUTER DR
Second Line :
City : RALEIGH
State : NC
Zip : 27609-6503
Country : US
Telephone Number : 919-781-6200
Fax Number : 919-783-1819
Provider Business Practice Location Address
First Line : 3805 COMPUTER DR
Second Line :
City : RALEIGH
State : NC
Zip : 27609-6503
Country : US
Telephone Number : 919-781-6200
Fax Number : 919-783-1819
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 07/22/2010

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