Provider Demographics
NPI:1265972350
Name:SHIELDS, KEITH D'ALTON (PA-C)
Entity type:Individual
Prefix:MR
First Name:KEITH
Middle Name:D'ALTON
Last Name:SHIELDS
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:106 NATE WHIPPLE HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-1403
Mailing Address - Country:US
Mailing Address - Phone:401-658-2020
Mailing Address - Fax:401-658-3612
Practice Address - Street 1:106 NATE WHIPPLE HWY STE 101
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-1403
Practice Address - Country:US
Practice Address - Phone:401-658-2020
Practice Address - Fax:401-658-3612
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2025-07-28
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant