Doctor Name: | STEVEN SHALIBO |
NPI Number: | 1033516919 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 65361 |
Business Practice Address: | 1616 Westgate Cir Brentwood, TN - 370278571 |
Business Phone Number: | 6156184465 |
Business Fax Number: | 6152610522 |
Mailing Address: | 1616 Westgate Cir, BRENTWOOD |
State: | TN |
Postal Code: | 370278571 |
Phone Number: | 6156184465 |
Fax Number: | 6152610522 |
NPI Enumeration Date: | 11/20/2014 |
NPI Last Update Date: | 11/20/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171WH0202X |
License Number: | 65361 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | Home Modifications |
Taxonomy Definition: |