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NPI Code Detail

MEDICARE: JOHN DANIEL SHEPPARD II PT

MEDICARE:   JOHN DANIEL SHEPPARD II PT
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
1225100000XPhysical Therapist013761OH
2225100000XPhysical Therapist25531MD

General Provider Information

NPI Number : 1952659526
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN DANIEL SHEPPARD II PT
Provider Business Mailing Address
First Line : PO BOX 791217
Second Line :
City : BALTIMORE
State : MD
Zip : 21279-1217
Country : US
Telephone Number : 301-932-4785
Fax Number : 301-932-4789
Provider Business Practice Location Address
First Line : 60 MARKET ST STE 206
Second Line :
City : GAITHERSBURG
State : MD
Zip : 20878-6559
Country : US
Telephone Number : 301-990-9599
Fax Number : 301-990-2899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2012
Last Update Date : 10/13/2022

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