Provider Demographics
NPI:1659388726
Name:SHEARER, DAVID A (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:SHEARER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10060 DEMIA WAY
Mailing Address - Street 2:THE DERMATOLOGY CENTER
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042
Mailing Address - Country:US
Mailing Address - Phone:859-525-6770
Mailing Address - Fax:859-525-7990
Practice Address - Street 1:10060 DEMIA WAY
Practice Address - Street 2:THE DERMATOLOGY CENTER
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042
Practice Address - Country:US
Practice Address - Phone:859-525-6770
Practice Address - Fax:859-525-7990
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2010-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY16310207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64163108Medicaid
KY1164301Medicare PIN
KY64163108Medicare Oscar/Certification
C70902Medicare UPIN
KYC70902Medicare UPIN