MEDICARE: DR. SHAWN ALLEN MCGIVNEY M.D.

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	179171	NY
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	10850	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427259209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAWN ALLEN MCGIVNEY M.D.

Provider Business Mailing Address
First Line	:	2232 S NELLIS BLVD # G3-173
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-6213
Country	:	US
Telephone Number	:	775-828-9435
Fax Number	:

Provider Business Practice Location Address
First Line	:	2232 S NELLIS BLVD # G3-173
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-6213
Country	:	US
Telephone Number	:	775-828-9435
Fax Number	:

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

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	09/15/2010

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