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NPI Code Detail

MEDICARE: MR. DAVID W SHEPHERD CRNA, MSN

MEDICARE: MR. DAVID W SHEPHERD CRNA, MSN
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
1367500000XCertified Registered Nurse Anesthetist28100574AIN

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 : 1942266911
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID W SHEPHERD CRNA, MSN
Provider Business Mailing Address
First Line : 160 STONEY CREEK CT
Second Line :
City : BLUFFTON
State : IN
Zip : 46714-9396
Country : US
Telephone Number : 260-824-8105
Fax Number :
Provider Business Practice Location Address
First Line : 303 S MAIN ST
Second Line :
City : BLUFFTON
State : IN
Zip : 46714-2503
Country : US
Telephone Number : 260-824-3210
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 12/09/2011

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