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Individual

JUSTIN L SHIELDS III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
540 FONTAINE ST, PENSACOLA, FL 32503-2019
(850) 484-4775
(850) 484-4775
Mailing address
PO BOX 1555, GULF BREEZE, FL 32562-1555
(850) 484-4775
(850) 484-4775

Taxonomy

Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
ME45060
FL

Other

Enumeration date
07/17/2006
Last updated
07/08/2007
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