| Doctor Name: | DR. JONATHAN JOEL SHEPHERD |
| NPI Number: | 1902096050 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | D0070538 |
| Business Practice Address: | 6707 Whitestone Rd Suite 106 Woodlawn, MD - 212074106 |
| Business Phone Number: | 4102658737 |
| Business Fax Number: | 4102651258 |
| Mailing Address: | 18 Breton Hill Rd, Apt. #3b PIKESVILLE |
| State: | MD |
| Postal Code: | 212082716 |
| Phone Number: | 3123917437 |
| Fax Number: | |
| NPI Enumeration Date: | 07/25/2007 |
| NPI Last Update Date: | 02/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084P0804X |
| License Number: | D0070538 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Child & Adolescent Psychiatry |
| Taxonomy Definition: | Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |