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Individual
DR. GARY N SHIELDS
Active
Individual
DR. GARY N SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000820
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008003499
—
CT
05
—
041318600
—
FL
01
—
261444569
PALMETTO GBA DME
SC
01
—
614459
CONNECTICARE
CT
01
—
6145090001
DMEPOS
CT
01
—
6240129
CINGA
CT
Enumeration date
07/24/2006
Last updated
07/28/2009
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