Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Shawn Jeffrey Moulder, DO

Individual provider Surgery Physician · NPI 1770964496

Dr. Shawn Jeffrey Moulder, DO is a General Surgery in Dearborn, Michigan. Graduated from Kansas City University of Med & Biosciences, College of Osteo Med in 2015, 11 years ago. Practices with Urgent Specialty Associates PLLC, a 57-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
11
Trained at
Kansas City University of Med & Biosciences, College of Osteo Med
Licensed in
MI
In the registry since
2015
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone: (313) 593-7000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 5101022023 (MI)

Record details

NPI number1770964496
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 18, 2015
Last updated in NPPESJune 18, 2015
Mailing address19756 S Glen Blvd, Apt C, Brownstown Twp, MI 48183-4928

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolKANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
Graduated 2015 (11 years in practice)
Group practice Urgent Specialty Associates Pllc — 57 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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