Individual
DR. DAVID TYLER SHIELDS NEUBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 TERRA CROSSING BLVD # 101, LOUISVILLE, KY 40245-5395
(502) 210-4600
(502) 210-4602
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
56833
KY
207QS0010X
Sports Medicine (Family Medicine) Physician
56833
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300065259
—
IN
05
—
7100832740
—
KY
Enumeration date
04/08/2019
Last updated
08/15/2022
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