Provider Demographics
NPI:1649599903
Name:SHIELD, DAVID RAUSCHENBERG (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RAUSCHENBERG
Last Name:SHIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:CHARLES
Other - Last Name:SHIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:40 MAIN ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-1492
Mailing Address - Country:US
Mailing Address - Phone:413-584-6422
Mailing Address - Fax:413-584-4346
Practice Address - Street 1:40 MAIN ST
Practice Address - Street 2:SUITE 106
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-1492
Practice Address - Country:US
Practice Address - Phone:413-584-6422
Practice Address - Fax:413-584-4346
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261632207W00000X
CT52728207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ54701OtherBCBS OF MASS
MAS400228650Medicare PIN