Lively, Michael Shawn
Lively, Michael Shawn is an sole proprietor health care provider with primary practice located at 710 Water St , Kerrville TX 78028-5329. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Lively, Michael Shawn can be contacted via phone (830) 258-7747.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | M3632 | Texas |
Profile Details
| NPI number | 1962460303 |
|---|---|
| LBN Legal business name | Lively, Michael Shawn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 3rd, 2006 |
| Last updated | May 12th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962460303 | NPPES |
| Texas | Other | 8M6794 | BCBS |
| Texas | Other | 180018702 | BCBS |
| Texas | MEDICAID | 180018701 | BCBS |
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