Individual
DR. MARC DOUGLAS SHIELDS
Active
Individual
DR. MARC DOUGLAS SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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