Individual
DR. TIMOTHY S SHAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1921 N WEBB RD, WICHITA, KS 67206-3405
(316) 612-4815
(316) 612-4825
Mailing address
1921 N WEBB RD, WICHITA, KS 67206-3405
(316) 612-4815
(316) 681-0244
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
0424526
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060097
MEDICARE
—
05
—
100158340C
—
KS
Enumeration date
06/21/2005
Last updated
10/28/2020
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