Provider Demographics
NPI:1740310804
Name:SHEPPERSON, STANLEY MCDONALD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:MCDONALD
Last Name:SHEPPERSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6445 LUZON AVE NW
Mailing Address - Street 2:APT 512
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-3021
Mailing Address - Country:US
Mailing Address - Phone:202-726-5582
Mailing Address - Fax:
Practice Address - Street 1:NATIONAL NAVAL MEDICAL CTR
Practice Address - Street 2:8901 WISCONSIN AVENUE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-319-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14595183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist