Theodore Shively, D.O

NPI 1780666461 · on the registry since 2005

Practice

Address: 39555 W 10 Mile Rd
Suite 302
Novi, MI 48375
Phone: (248) 426-7200
Organisation at this address: Kelly M Krueger Do Pllc
Primecare Urgent Care Pllc
Richard M Newman D.C. P.C.
Michael P. Burk, D.P.M., Pllc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 14

Registry record

Primary taxonomy: 207Q00000X
207Q00000X
Also registered as: 207QG0300X
Licence states on file: MI
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2011-12-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan