Individual
DR. DOUGLAS A. SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 HOSPITAL DR, SPRUCE PINE, NC 28777-3035
(828) 765-4201
Mailing address
PO BOX 98, JONAS RIDGE, NC 28641-0098
(828) 385-0915
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E4736
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00125794
—
MS
05
—
010210364
—
VA
05
—
162345001
—
AR
05
—
204445209
—
MO
05
—
3813511
—
TN
05
—
3813512
—
TN
01
—
50007474
PASSPORT HEALTH
KY
05
—
5630460000
—
WV
05
—
64338304
—
KY
01
—
P0029524
MEDICARE RAILROAD
WV
01
—
P00378743
MEDICARE RAILROAD
AR
01
—
P00384358
MEDICARE RAILROAD
KY
Enumeration date
07/25/2006
Last updated
05/02/2012
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