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General NPI Number Information
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NPI Number | 1679657902
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Entity Type | Organization
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Legal Business Name | DAVID S SHIELDS, MD, LLC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2950 COLLEGE DR SUITE 2A
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City | VINELAND
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State | NJ
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Zip | 08360
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Country | US
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Telephone | 856-691-1129
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Fax | 856-691-1229
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Provider Business Mailing Address
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Address Line | 2950 COLLEGE DR SUITE 2A
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City | VINELAND
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State | NJ
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Zip | 08360
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Country | US
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Telephone | 856-691-1129
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Fax | 856-691-1229
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DAVID S SHIELDS
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Credential | MD
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Telephone | 856-691-1129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MA55507
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License Number State | NJ
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