Organization
W J SHIELDS M D
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY A HADSELL (OFFICE MANAGER)
(757) 874-0320
Entity
Organization
Contact information
Practice address
914 DENBIGH BLVD, GRAFTON, VA 23692-2156
(757) 874-0320
(757) 989-0276
Mailing address
PO BOX 2696, NEWPORT NEWS, VA 23609-0696
(757) 874-0320
(757) 989-0276
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101024156
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002959
ANTHEM
VA
05
—
5969115
—
VA
Enumeration date
02/28/2008
Last updated
02/28/2008
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