Myra Shivers is a Periodontics in Fayetteville, Georgia. Myra Shivers practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Myra Shivers is 1235355017. The last update date is 2007-07-08.
Myra Shivers's current location address is 118 N Park Dr, Fayetteville, Georgia. You can contact this provider via phone number 7704606765 and fax number 7704605598. The mailing address for Myra Shivers is 118 N Park Dr, Fayetteville, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Myra Shivers |
|---|---|
| Address | 118 N Park Dr, Fayetteville, Georgia |
| Phone Number | 7704606765 |
| Fax Number | 7704605598 |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1235355017 |
|---|---|
| Provider Enumeration Date | 2007-04-18 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 118 N Park Dr |
|---|---|
| City | Fayetteville |
| State | Georgia (GA) |
| Post Code | 302141645 |
| Phone Number | 7704606765 |
| Fax Number | 7704605598 |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 9975 |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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What is the unique 10-digit identifier code issued to Myra Shivers by the Centers for Medicare & Medicaid Services?
The Myra Shivers has been assigned the NPI (National Provider Identifier) 1235355017 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Myra Shivers is located?
The Myra Shivers is situated at the following address: 118 N Park Dr, Fayetteville, GA, 302141645.
What is Myra Shivers's area of expertise and its corresponding taxonomy classification?
The Myra Shivers's field of specialization is Periodontics, and it falls under the taxonomy code 1223P0300X, which categorizes healthcare providers based on their areas of practice.
When did the Myra Shivers receive its 1235355017?
The Myra Shivers was issued its 1235355017 on 2007-04-18, which is the date when the organization was assigned this unique identifier.
When was the information regarding Myra Shivers most recently updated?
The details pertaining to the Myra Shivers, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.
NPI Number: 1316940851
Address: 2410 N Glendale Dr Ste A, Fort Wayne, IN