Individual
KYLE JOHN SHAVER
Active
Individual
KYLE JOHN SHAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD27338
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055542005
BCBS
—
05
—
057237
—
OR
01
—
56097
WA L & I
—
01
—
930021553
RAILROAD
—
01
—
C98636
PROVIDENCE
—
Enumeration date
11/14/2006
Last updated
12/04/2023
Update your record
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