Individual
GREGORY WILLIAM SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1108 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 793-8087
(334) 793-8191
Mailing address
PO BOX 1928, DOTHAN, AL 36302-1928
(334) 793-8087
(334) 793-8191
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
00014931
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000091248
—
AL
01
—
051007047
BCBS AL
AL
05
—
061675300
—
FL
05
—
537850840B
—
GA
Enumeration date
05/02/2006
Last updated
05/23/2008
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