Provider Demographics
NPI:1346839503
Name:SHEPHERD, WILLIAM DAVID
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DAVID
Last Name:SHEPHERD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6484 SHERMAN TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-9076
Mailing Address - Country:US
Mailing Address - Phone:513-836-1959
Mailing Address - Fax:
Practice Address - Street 1:6484 SHERMAN TERRACE DR
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-9076
Practice Address - Country:US
Practice Address - Phone:513-836-1959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care