Individual
RUTH L SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3151B MIDTOWN PARK S, MOBILE, AL 36606-4146
(251) 206-8751
(251) 471-9505
Mailing address
3151B MIDTOWN PARK S, MOBILE, AL 36606-4146
(251) 206-8751
(251) 471-9505
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
00004527
AL
208D00000X
General Practice Physician
Primary
4527
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011846
MEDICARE GROUP NUMBER
AL
01
—
1063439065
NPI SITE GROUP PAYEE NUMBER
AL
05
—
630000013
—
AL
Enumeration date
05/26/2006
Last updated
08/06/2015
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