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Individual
DR. DOUGLAS A. SHIELDS
Active
Individual
DR. DOUGLAS A. SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E4736
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00125794
—
MS
05
—
010210364
—
VA
05
—
162345001
—
AR
05
—
204445209
—
MO
05
—
3813511
—
TN
05
—
3813512
—
TN
01
—
50007474
PASSPORT HEALTH
KY
05
—
5630460000
—
WV
05
—
64338304
—
KY
01
—
P0029524
MEDICARE RAILROAD
WV
01
—
P00378743
MEDICARE RAILROAD
AR
01
—
P00384358
MEDICARE RAILROAD
KY
Enumeration date
07/25/2006
Last updated
05/02/2012
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