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NPI Code Detail

MEDICARE: MAX RONALD SHIVER MD

MEDICARE: MAX RONALD 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
1207R00000XInternal Medicine PhysicianMD.8463AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1234255OTHERGABC/BS GEORGIA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3051060676OTHERALBC/BS ALABAMA
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184623241
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAX RONALD SHIVER MD
Provider Business Mailing Address
First Line : 102 WOODMONT BLVD STE 600
Second Line :
City : NASHVILLE
State : TN
Zip : 37205-5250
Country : US
Telephone Number : 615-314-5257
Fax Number : 615-692-0547
Provider Business Practice Location Address
First Line : 9174 PARKWAY E
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35206-1507
Country : US
Telephone Number : 205-498-2675
Fax Number : 205-498-2676
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 05/18/2022

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Directions to “ MAX RONALD SHIVER MD” Practice Location

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