Organization
EMERGENCY MEDICAL SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAX RONALD SHIVER (CEO)
(706) 643-1073
Entity
Organization
Contact information
Practice address
4800 48TH ST, VALLEY, AL 36854-3666
(334) 756-9180
Mailing address
PO BOX 686, WEST POINT, GA 31833-0686
(706) 643-1073
(706) 643-1070
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
12/12/2006
Last updated
08/22/2020
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