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WILLIAM JENNINGS SHIELDS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
914 DENBIGH BLVD, GRAFTON, VA 23692
(757) 874-0320
(757) 989-0276
Mailing address
PO BOX 2696, NEWPORT NEWS, VA 23609
(757) 874-0320
(757) 989-0276

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101024156
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002959
BCBS
VA
05
5969115
VA
Enumeration date
04/08/2006
Last updated
07/08/2007
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