| Dr. Robert Shepherd, Pa | |
|
2415 Emerson Ave S Minneapolis MN 55405-2602 | |
| (612) 872-9133 | |
| (612) 872-0342 |
| Full Name | Dr. Robert Shepherd, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 2415 Emerson Ave S, Minneapolis, Minnesota |
| Authorized Official Name and Position | Robert C Shepherd (OWNER) |
| Authorized Official Contact | 6128729133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Robert Shepherd, Pa 2415 Emerson Ave S Minneapolis MN 55405-2602 Ph: (612) 872-9133 | Dr. Robert Shepherd, Pa 2415 Emerson Ave S Minneapolis MN 55405-2602 Ph: (612) 872-9133 |
| NPI Number | 1487838603 |
|---|---|
| Provider Enumeration Date | 12/24/2007 |
| Last Update Date | 12/24/2007 |
| Medicare PECOS PAC ID | 7618048414 |
|---|---|
| Medicare Enrollment ID | O20080626000429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487838603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2986 (Minnesota) | Primary |
| Provider Name | Robert C Shepherd |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1366544587 PECOS PAC ID: 9739135518 Enrollment ID: I20050324000441 |
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