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Individual

MICHAEL E SHIVERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
620 HOWARD AVE, ALTOONA, PA 16601-4804
(814) 889-2854
(814) 889-7982
Mailing address
620 HOWARD AVE, ALTOONA, PA 16601-4804
(814) 889-2854
(814) 889-7982

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD061239L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0017715150002
PA
01
02094901
CAPITAL BLUE CROSS
PA
05
02662857
NY
05
4098026800
MD
01
SH750404
HIGHMARK
PA
Enumeration date
04/27/2006
Last updated
01/15/2016
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