Individual
PHILLIP AUDRA SHRIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2880 INTERNATIONAL CIR # N010, COLORADO SPRINGS, CO 80910-3127
(719) 520-7080
(719) 520-7086
Mailing address
340 PRINTERS PKWY, COLORADO SPRINGS, CO 80910-3190
(719) 632-5700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42075
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35001577
—
CO
Enumeration date
02/12/2007
Last updated
12/20/2019
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