Provider Demographics
NPI:1437115755
Name:SHIELDS, STEPHEN LLOYD (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:LLOYD
Last Name:SHIELDS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 ROUTE 111
Mailing Address - Street 2:VILLAGE SQUARE PLAZA
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03841-2371
Mailing Address - Country:US
Mailing Address - Phone:603-329-9333
Mailing Address - Fax:603-329-5090
Practice Address - Street 1:472 ROUTE 111
Practice Address - Street 2:VILLAGE SQUARE PLAZA
Practice Address - City:HAMPSTEAD
Practice Address - State:NH
Practice Address - Zip Code:03841-2371
Practice Address - Country:US
Practice Address - Phone:603-329-9333
Practice Address - Fax:603-329-5090
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH035-0790111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANA1549OtherHARVARD PILGIRM HEALTHCAR
MAY39911OtherBCBS MASSACHUSETTES
NH80003512Medicaid
NH0504442Y0NH02OtherANTHEM BCBS
NH44-00187OtherUNITED HEALTHCARE
MA035079OtherTUFTS HEALTH PLANS
NH1162609OtherAETNA
NH44-00187OtherUNITED HEALTHCARE