Provider Demographics
NPI:1912980947
Name:SHEPRO, DAVID SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SCOTT
Last Name:SHEPRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 LEXINGTON CIRCLE
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520
Mailing Address - Country:US
Mailing Address - Phone:617-835-3146
Mailing Address - Fax:508-519-8400
Practice Address - Street 1:48 LEXINGTON CIRCLE
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520
Practice Address - Country:US
Practice Address - Phone:617-835-3146
Practice Address - Fax:508-519-8400
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55686207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110048375AMedicaid
MA110048375AMedicaid
MA2544419OtherAETNA US HEALTH
MA9056OtherHARVARD PILGRIM
MA3548134OtherCIGNA
MAJ09862OtherBLUE CROSS BLUE SHIELD
MA2544419OtherAETNA US HEALTH
MA110048375AMedicaid