MEDICARE: PATRICIA D SHEARER 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
1	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	080510	GA
2	208000000X	Pediatrics Physician	80510	GA
3	2080P0207X	Pediatric Hematology & Oncology Physician	80510	GA
4	2080H0002X	Pediatric Hospice and Palliative Medicine Physician	80510	GA

Other Identifiers

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

General Provider Information

NPI Number	:	1710902820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA D SHEARER MD

Provider Business Mailing Address
First Line	:	1086 ARBOR TRCE NE
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-5378
Country	:	US
Telephone Number	:	404-986-8756
Fax Number	:	404-986-0803

Provider Business Practice Location Address
First Line	:	1086 ARBOR TRCE NE
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-5378
Country	:	US
Telephone Number	:	404-986-8756
Fax Number	:	404-986-0803

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	09/24/2021

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Directions to “ PATRICIA D SHEARER MD” Practice Location

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