Individual
GREGORY SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
557 BROOKDALE DR, STATESVILLE, NC 28677-4107
(704) 873-5661
Mailing address
261 SUNDANCE CIR, STATESVILLE, NC 28625
(704) 880-4319
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-13325
NC
Other
Enumeration date
03/22/2023
Last updated
07/05/2023
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