RUSSELL B SHIELDS MD PC NPI 1477543213

NPI Information

  • NPI: 1477543213
  • Provider Name: RUSSELL B SHIELDS MD PC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 425 MEDICAL DR
    STE 108
    BOUNTIFUL, UT
    ZIP 84010
  • Phone: (801) 292-8444

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NPI Details

RUSSELL B SHIELDS MD PC is a family medicine in Bountiful, UT. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. RUSSELL B SHIELDS MD PC NPI is 1477543213. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

425 MEDICAL DR
STE 108
BOUNTIFUL, UT
ZIP 84010-945
Phone: (801) 292-8444
Fax: (801) 292-8476

The provider's authorized official is Russell Brent Shields .
The authorized official title is President and has the following contact phone number (801) 292-8444.

The enumeration date for this NPI number is 10/24/2005 and was last updated on 4/8/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1DG2545MEDICARE PINUTAH
2528566304004MEDICAIDUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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