Organization Name: | MARGARET L SHIELDS INC |
NPI Number: | 1033423504 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARGARET L SHIELDS (PRESIDENT) |
Mailing Address: | 11132 South Towne Square Ste 105 St Louis |
State: | MO US |
Postal Code: | 63123 |
Phone Number: | 3148921442 |
Fax Number: | 3148924523 |
NPI Enumeration Date: | 07/27/2010 |
NPI Last Update Date: | 08/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 2007022634 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |