Provider Demographics
NPI:1215145701
Name:SHEPARD & LUGERNER, MD PC
Entity type:Organization
Organization Name:SHEPARD & LUGERNER, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-429-2401
Mailing Address - Street 1:2021 K ST NW STE 310
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1015
Mailing Address - Country:US
Mailing Address - Phone:202-429-2401
Mailing Address - Fax:202-429-4341
Practice Address - Street 1:2021 K ST NW STE 310
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1015
Practice Address - Country:US
Practice Address - Phone:202-429-2401
Practice Address - Fax:202-429-4341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC12080174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC153124Medicare ID - Type Unspecified
C62682Medicare UPIN