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Contact Information

GARY N SHIELDS, DPM
340 BANTAM RD
SUITE 1-B
LITCHFIELD, CT06759-3318
 Phone: 860-567-1600
 Fax: 860-567-1606
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for GARY N SHIELDS · (Male)

NPI # 1073535456
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 07/24/2006
Last updated 07/28/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 000820
  • CT Medicaid 008003499
  • FL Medicaid 041318600
  • CT Other 6240129 CINGA
  • CT Other 614459 CONNECTICARE
  • CT Other 6145090001 DMEPOS
  • SC Other 261444569 PALMETTO GBA DME
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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