Individual
MERRICK LEE SHIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, RPH
Contact information
Practice address
1055 DIVIDE VIEW DR, GOLDEN, CO 80403-9787
(303) 808-6401
Mailing address
1055 DIVIDE VIEW DR, GOLDEN, CO 80403-9787
(303) 808-6401
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
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