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General NPI Number Information
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NPI Number | 1447240262
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Entity Type | Individual
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Provider Name | DANIEL A SHIELDS MD
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Gender | Male
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Dates
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Enumeration Date | 10/24/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 309 11TH ST
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City | CARROLLTON
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State | KY
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Zip | 41008-1435
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Country | US
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Telephone | 502-732-4321
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 511
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City | DRY RIDGE
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State | KY
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Zip | 41035-0511
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Country | US
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Telephone | 859-824-5375
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25514
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 25514
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License Number State | KY
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