| NPI | 1679239727 |
|---|---|
| Doing Business As | R. MARK SHIVERS SOLE MBR |
| Entity Type | Organization |
| Authorized Contact | RICHARD MARK SHIVERS Owner / Md 330-614-8411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2021-11-12 |
| Last Update Date | 2021-11-16 |