Provider Demographics
NPI:1659373561
Name:SHIELDS, ROBERT LLOYD (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LLOYD
Last Name:SHIELDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:303-493-7000
Mailing Address - Fax:
Practice Address - Street 1:12605 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2545
Practice Address - Country:US
Practice Address - Phone:720-848-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO21442174400000X, 207W00000X
CODR.0021442207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No174400000XOther Service ProvidersSpecialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01214428Medicaid
NE84145236900Medicaid
WY104529600/42BE00AGMedicaid
CO04685822/01214428Medicaid
CA6594832Medicaid
KS100116070CMedicaid
CO920684OtherEYE SPECIALIST
CO814649/4250186/20059OtherAETNA
NM000041311Medicaid
KS100116070CMedicaid
CO04685822/01214428Medicaid
CO04685822/01214428Medicaid
COCO307190Medicare PIN