Individual
DR. MARC DOUGLAS SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 COMMERCE RD, STAUNTON, VA 24401-9032
(540) 213-7720
(540) 213-9441
Mailing address
17 N MEDICAL PARK DR, FISHERSVILLE, VA 22939-2344
(540) 213-7720
(540) 213-7728
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101236216
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010058228
—
VA
05
—
010058244
—
VA
05
—
010058252
—
VA
01
—
137003
BLUE CROSS BLUE SHIELD
VA
01
—
137008
BLUE CROSS BLUE SHIELD
VA
01
—
137010
BLUE CROSS BLUE SHIELD
VA
Enumeration date
05/24/2005
Last updated
07/08/2020
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