Organization
SHIELDS AND SHIELDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY A SHIELDS MD (DIRECTOR)
(215) 928-3105
Entity
Organization
Contact information
Practice address
840 WALNUT STREET, SUITE 1440, PHILADELPHIA, PA 19107
(215) 928-3105
(215) 928-1140
Mailing address
840 WALNUT STREET, SUITE 1440, PHILADELPHIA, PA 19107
(215) 928-3105
(215) 928-1140
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017615000005
—
PA
Enumeration date
10/12/2006
Last updated
04/20/2020
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