Individual
SELBY B SHIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
907 E LAMAR ALEXANDER PKWY, MARYVILLE, TN 37804-5015
(865) 983-7211
(865) 450-9374
Mailing address
PO BOX 24776, CHATTANOOGA, TN 37422-4776
(877) 288-1799
(423) 892-5838
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
17667
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3028803
BLUE CROSS BLUE SHIELD TN
TN
05
—
3047651
—
TN
Enumeration date
11/04/2005
Last updated
12/02/2010
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