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NPI Code Detail

MEDICARE: CHARLES A SHEPPARD

MEDICARE: CHARLES A SHEPPARD
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1710833413
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES A SHEPPARD
Provider Business Mailing Address
First Line : 16 W LONG ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-2815
Country : US
Telephone Number : 614-225-0990
Fax Number : 614-225-0988
Provider Business Practice Location Address
First Line : 16 W LONG ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-2815
Country : US
Telephone Number : 614-225-0990
Fax Number : 614-225-0988
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2026
Last Update Date : 03/06/2026

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Directions to “ CHARLES A SHEPPARD ” Practice Location

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