Individual
CASSIDY MICHAELA SHIVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1530 UNION RD STE A, GASTONIA, NC 28054-2201
(704) 867-6188
(704) 866-4437
Mailing address
1530 UNION RD STE A, GASTONIA, NC 28054-2201
(704) 867-6188
(704) 866-4437
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-12609
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/16/2022
Last updated
11/09/2022
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