MEDICARE: S MCGIVNEY LTD.

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	10850	NV

General Provider Information

NPI Number	:	1922250075
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S MCGIVNEY LTD.

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	:	PRESIDENT
Name	:	DR. SHAWN ALLEN MCGIVNEY
Credential	:	M.D.
Telephone Number	:	775-828-9435

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	10/21/2008

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