DR. Kenneth Daniel Shively, M.D.

NPI #1932183449 in Laporte, Indiana

Provider Information

NPI Number: 1932183449
Entity Type: Individual
Name: DR. Kenneth Daniel Shively, M.D.
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Family Medicine
Credential: M.D.
Enumeration Date: Nov 30, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 900 I ST
City: Laporte
State: Indiana
ZIP Code: 46350-5533
Phone: (219) 324-1950

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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