DR. STEPHEN WYATT SHIELD M.D.
Allergy and Immunology
Williamsburg, Virginia
Provider NPI: 1073590071
Provider Information:DR. STEPHEN WYATT SHIELD M.D.
Practice Location:
1144 PROFESSIONAL DR WILLIAMSBURG, VA 23185 US
Tel: 757-259-0443 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207K00000X | Physicians Allergy & Immunology | VA | 0101049643 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| ANTHEM | 250532 | VA | 01 |
| MAMSI | 271568 | VA | 01 |
| SOUTHERN HEALTH | 84330 | VA | 01 |
| MEDICARE PTAN | 00Y225A01 | VA | 01 |
| 1073590071 | VA | 05 | |
| SENTERA | 17424 | VA | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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