Basic Information
| Provider Information | |||||||||
| NPI: | 1194221713 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHIELDS | ||||||||
| FirstName: | MARGARET | ||||||||
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| Mailing Information | |||||||||
| Address1: | 617 WILLIAMSON RD | ||||||||
| Address2: | |||||||||
| City: | BRYN MAWR | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190101932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153136299 | ||||||||
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| Practice Location | |||||||||
| Address1: | 800 WASHINGTON ST | ||||||||
| Address2: | TMC BOX #306 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176365172 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2018 | ||||||||
| LastUpdateDate: | 06/01/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 275515 | MA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.