Nicole Petersen Shepard MD

NPI 1063546737 - Pediatrics - 208000000X

NPI Details
NPI 1063546737
Gender Female
Enumeration Date 03/15/2007
Last Updated 12/18/2012
Entity Type Individual
Active Over 9 years ago
Practice Location
171 ASHLEY AVE
CHARLESTON SC, 29425-8908, US
Phone (843) 792-1414
Fax
Business Location
PO BOX 751461
CHARLOTTE NC, 28275-1461, US
Phone (843) 792-6200
Fax
Toxanomy
Taxonomy Code 208000000X
License State Georgia
License Number 040999
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According to our database, Dr. Nicole Petersen Shepard MD NPI is 1063546737, taxonomy code is 208000000X and license number is 040999, license state is located at Georgia. Nicole Petersen Shepard MD physically located at 171 Ashley Ave, Charleston SC, 29425-8908. NPI Number Nicole Petersen Shepard MD has the Individual type.

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1063546737 NPI number is provided on an as is basis without warranty of any kind. 1063546737 is maintained by the National Plan & Provider Enumeration System. The contents of Nicole Petersen Shepard MD are for informational purposes only.