Individual
DR. RAYMOND TODD SHAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC DICCP
Contact information
Practice address
4421 JUNCTION PARK DRIVE, SUITE 100, WILMINGTON, NC 28412-2263
(910) 452-5555
(910) 452-5044
Mailing address
4421 JUNCTION PARK DRIVE, SUITE 100, WILMINGTON, NC 28412-2263
(910) 452-5555
(910) 452-5044
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1781
NC
111NP0017X
Pediatric Chiropractor
1781
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0877B
BCBS
NC
01
—
2446941A
MEDICARE INDIVIDUAL PROVIDER PTAN
NC
01
—
2446941B
MEDICARE GROUP PROVIDER PTAN
NC
05
—
890877B
—
NC
Enumeration date
09/20/2006
Last updated
05/06/2014
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