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1407177652

NPI Code Detail

MEDICARE: DR. AUSTIN LUKE SHIVER MD

MEDICARE: DR. AUSTIN LUKE SHIVER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	4239	GA
2	207X00000X	Orthopaedic Surgery Physician	2024-00732	NC
3	207XS0106X	Orthopaedic Hand Surgery Physician	69639	GA

General Provider Information

NPI Number	:	1407177652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUSTIN LUKE SHIVER MD

Provider Business Mailing Address
First Line	:	1120 15TH ST # R2029
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30912-0004
Country	:	US
Telephone Number	:	706-721-8623
Fax Number	:

Provider Business Practice Location Address
First Line	:	1220 W WHEELER PKWY
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30909-6625
Country	:	US
Telephone Number	:	706-721-2741
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2010
Last Update Date	:	03/02/2026

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Directions to “ DR. AUSTIN LUKE SHIVER MD” Practice Location

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