Provider Demographics
NPI:1346429800
Name:SHAWN MICHAEL FIELD MD PHD LLC
Entity Type:Organization
Organization Name:SHAWN MICHAEL FIELD MD PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:732-888-4100
Mailing Address - Street 1:226 MIDDLE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1945
Mailing Address - Country:US
Mailing Address - Phone:732-888-4100
Mailing Address - Fax:732-888-0430
Practice Address - Street 1:226 MIDDLE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1945
Practice Address - Country:US
Practice Address - Phone:732-888-4100
Practice Address - Fax:732-888-0430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH59702Medicare UPIN
NJ057427Medicare PIN