1437115755 NPI number — DR. STEPHEN LLOYD SHIELDS D.C.

Table of content: (NPI 1578617742)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437115755 NPI number — DR. STEPHEN LLOYD SHIELDS D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHIELDS
Provider First Name:
STEPHEN
Provider Middle Name:
LLOYD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437115755
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
472 ROUTE 111
Provider Second Line Business Mailing Address:
VILLAGE SQUARE PLAZA
Provider Business Mailing Address City Name:
HAMPSTEAD
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03841-2371
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-329-9333
Provider Business Mailing Address Fax Number:
603-329-5090

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
472 ROUTE 111
Provider Second Line Business Practice Location Address:
VILLAGE SQUARE PLAZA
Provider Business Practice Location Address City Name:
HAMPSTEAD
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03841-2371
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-329-9333
Provider Business Practice Location Address Fax Number:
603-329-5090
Provider Enumeration Date:
04/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  035-0790 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: NA1549 . This is a "HARVARD PILGIRM HEALTHCAR" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: Y39911 . This is a "BCBS MASSACHUSETTES" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 80003512 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0504442Y0NH02 . This is a "ANTHEM BCBS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 44-00187 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 035079 . This is a "TUFTS HEALTH PLANS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1162609 . This is a "AETNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




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