MEDICARE: JOSHUA SHIELDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1316756976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA SHIELDS

Provider Business Mailing Address
First Line	:	2008 AIRPORT HWY
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43609-1824
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2008 AIRPORT HWY
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43609-1824
Country	:	US
Telephone Number	:	419-973-5650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2025
Last Update Date	:	01/08/2025

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Directions to “ JOSHUA SHIELDS ” Practice Location

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