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General NPI Number Information
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NPI Number | 1417320912
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Entity Type | Organization
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Legal Business Name | SHIELDS SIGNATURE IMAGING, LLC
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Dates
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Enumeration Date | 11/05/2015
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 680 CENTRE ST
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City | BROCKTON
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State | MA
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Zip | 02302-3308
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Country | US
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Telephone | 866-258-4738
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Fax |
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Provider Business Mailing Address
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Address Line | 700 CONGRESS ST STE 204
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City | QUINCY
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State | MA
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Zip | 02169-0928
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Country | US
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Telephone | 508-897-1501
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Fax | 508-897-1599
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Authorized Official
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Title or Position | CFO
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Name | KRISTEN DELMORE
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Credential |
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Telephone | 617-376-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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