Provider Demographics
NPI:1790724805
Name:SHEAR, DAVID STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:STEPHEN
Last Name:SHEAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:515 FAIRMOUNT AVE
Mailing Address - Street 2:CREDENTIALING DEPARTMENT
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5466
Mailing Address - Country:US
Mailing Address - Phone:410-494-1324
Mailing Address - Fax:410-494-1361
Practice Address - Street 1:515 FAIRMOUNT AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5466
Practice Address - Country:US
Practice Address - Phone:410-494-1397
Practice Address - Fax:410-494-1367
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD178800208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD184131900Medicaid
MD184131900Medicaid
MDD74443Medicare UPIN
MD158477ZD2XMedicare PIN
MD157676Medicare PIN