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NPI Code Detail

MEDICARE: DR. FRANK W SHIELDS IV MD

MEDICARE: DR. FRANK W SHIELDS IV MD
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
1390200000XStudent in an Organized Health Care Education/Training Program0116020468VA
22085R0202XDiagnostic Radiology Physician2011-00432NC

General Provider Information

NPI Number : 1740443878
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FRANK W SHIELDS IV MD
Provider Business Mailing Address
First Line : 14 GREYSTONE CT
Second Line :
City : DURHAM
State : NC
Zip : 27713-9362
Country : US
Telephone Number : 703-869-8798
Fax Number :
Provider Business Practice Location Address
First Line : 2006 OLD CLINIC
Second Line : CB #7510
City : CHAPEL HILL
State : NC
Zip : 27599-0001
Country : US
Telephone Number : 919-966-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2008
Last Update Date : 04/08/2014

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