Individual
CHRISTOPHER C SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1125 W ALAMEDA RD, POCATELLO, ID 83201-6143
(208) 237-1151
Mailing address
1125 W ALAMEDA RD, POCATELLO, ID 83201-6143
(208) 237-1151
Taxonomy
Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
M4528
ID
207Q00000X
Family Medicine Physician
M4528
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003933100
—
ID
Enumeration date
07/14/2005
Last updated
04/04/2018
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