Individual
PAUL L SHIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DMD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4301505261
MI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
4301505261
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1972913382
BWC
OH
Enumeration date
05/07/2014
Last updated
08/26/2025
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