Individual
DOUGLAS WILLIAM SHEVLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9705 LENEXA DR, LENEXA, KS 66215-1345
(913) 348-2565
Mailing address
14425 COLLEGE BLVD STE 130, LENEXA, KS 66215-2317
(913) 348-2565
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
036093225
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0436540
KS
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
2013018617
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0360932252
MEDICAID
IL
01
—
201073120A
KS MEDICAID
KS
01
—
2013018617
MO LICENSE
MO
01
—
PENDING
LA LICENSE
LA
Enumeration date
07/30/2006
Last updated
06/23/2022
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