Individual
JONATHAN DE SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10810 CONNECTICUT AVE, KENSINGTON, MD 20895-2138
(301) 297-1003
Mailing address
7651 WOODLAND DR, EASTON, MD 21601-8141
(410) 822-9685
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0092482
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2018
Last updated
12/19/2021
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