Individual
ROBERT MICHAEL SHIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18320 SO CENTER ST, GARDNER, KS 66030
(913) 856-5577
(913) 856-3907
Mailing address
18320 SO CENTER ST, GARDNER, KS 66030
(913) 856-5577
(913) 856-3907
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0422740
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10038320A
—
KS
Enumeration date
05/18/2006
Last updated
09/08/2011
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