| Doctor Name: | MICHAEL S DESHIELDS |
| NPI Number: | 1245345743 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 25MA04362400 |
| Business Practice Address: | 20 N Woodbury Turnersville Rd Blackwood, NJ - 080122888 |
| Business Phone Number: | 8563746740 |
| Business Fax Number: | 8563746520 |
| Mailing Address: | 20 N Woodbury Turnersville Rd, BLACKWOOD |
| State: | NJ |
| Postal Code: | 080122888 |
| Phone Number: | 8563746740 |
| Fax Number: | 8563746520 |
| NPI Enumeration Date: | 08/21/2006 |
| NPI Last Update Date: | 01/22/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | 25MA04362400 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |