Doctor Name: | SARAH-KIM SHIELDS |
NPI Number: | 1114214202 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 1742220 |
Business Practice Address: | 20 Catamore Blvd East Providence, RI - 02914 |
Business Phone Number: | 4014322500 |
Business Fax Number: | |
Mailing Address: | 20 Catamore Blvd, EAST PROVIDENCE |
State: | RI |
Postal Code: | 02914 |
Phone Number: | 4014322500 |
Fax Number: | 4014538220 |
NPI Enumeration Date: | 07/08/2011 |
NPI Last Update Date: | 05/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 1742220 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |