Shields, Thomas Matthew

Shields, Thomas Matthew is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Gastroenterology. Allopathic & Osteopathic Physicians / Pediatric Gastroenterology is his primary health care specialty. Shields, Thomas Matthew can be contacted via phone (774) 441-8082.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655-0002
Phone: (774) 441-8082
Fax: (774) 441-8056
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 260975 Massachusetts
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X 260975 Massachusetts

Profile Details

NPI number 1770745135
LBN Legal business name Shields, Thomas Matthew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2008
Last updated Nov 9th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770745135 NPPES
Massachusetts MEDICAID 110100482A

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