| Doctor Name: | PETER M. SHEPARD |
| NPI Number: | 1023051232 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | MD2009-0111 |
| Business Practice Address: | 1620 Hospital Dr Southwestern Ear Nose And Throat Associates Santa Fe, NM - 875054754 |
| Business Phone Number: | 5059824848 |
| Business Fax Number: | 5059841149 |
| Mailing Address: | 1620 Hospital Dr, Southwestern Ear Nose And Throat Associates SANTA FE |
| State: | NM |
| Postal Code: | 875054754 |
| Phone Number: | 5059824848 |
| Fax Number: | 5059841149 |
| NPI Enumeration Date: | 06/14/2006 |
| NPI Last Update Date: | 08/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207YX0905X |
| License Number: | MD2009-0111 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Otolaryngology |
| Taxonomy Specialization: | Otolaryngology/Facial Plastic Surgery |
| Taxonomy Definition: | An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |