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General NPI Number Information
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NPI Number | 1427062900
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Entity Type | Individual
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Provider Name | STEVEN R SHIELDS MD
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 11/05/2020
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Provider Practice Location Address
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Address Line | 1225 S GRAND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1016
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Country | US
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Telephone | 314-977-5200
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Fax | 314-977-3495
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Provider Business Mailing Address
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Address Line | 1831 CHESTNUT ST STE 650
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City | SAINT LOUIS
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State | MO
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Zip | 63103-2236
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Country | US
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Telephone | 314-977-6828
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Fax | 314-977-6872
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 104588
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License Number State | MO
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