Individual
MERRICK LEE SHIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, RPH
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
12517
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000
NONE
—
01
—
NONE
NONE
—
Enumeration date
03/30/2022
Last updated
03/30/2022
Update your record
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