Individual
DR. GREGG ALLEN SHIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 OLD DENBIGH BLVD STE 1020A, RIVERSIDE LIFELONG HEALTH & AGING SERVICES, NEWPORT NEWS, VA 23602-2017
(757) 875-2009
(757) 369-1042
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
(757) 594-4006
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101050193
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578502142
—
VA
Enumeration date
06/06/2006
Last updated
12/12/2016
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