Provider Demographics
NPI:1164555231
Name:SHIELDS MEDICAL ASSOCIATES, LLP
Entity Type:Organization
Organization Name:SHIELDS MEDICAL ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-691-3501
Mailing Address - Street 1:5325 NORTHGATE DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-9411
Mailing Address - Country:US
Mailing Address - Phone:610-691-3501
Mailing Address - Fax:610-691-3502
Practice Address - Street 1:5325 NORTHGATE DR
Practice Address - Street 2:SUITE 205
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9411
Practice Address - Country:US
Practice Address - Phone:610-691-3501
Practice Address - Fax:610-691-3502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072307L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02417400OtherCAPITAL BLUE CROSS
PA0999441OtherHIGHMARK BLUE SHIELD
PA0999441OtherHIGHMARK BLUE SHIELD