Shively, Donovan Paul
Shively, Donovan Paul is an sole proprietor health care provider with primary practice located at 4397 Edinburg Ct , Fairfield CA 94534. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Shively, Donovan Paul can be contacted via phone (707) 864-2311.Contact Information
Primary practice address
4397 Edinburg Ct
Fairfield CA 94534
Phone: (707) 864-2311
Fax: (707) 864-2317
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | G21888 | California |
Profile Details
| NPI number | 1063485217 |
|---|---|
| LBN Legal business name | Shively, Donovan Paul |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 8th, 2006 |
| Last updated | Oct 8th, 2009 - about 17 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 | 1063485217 | NPPES |
| California | MEDICAID | 00G218880 |
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