Provider Demographics
NPI:1750618344
Name:SHAVERS, ROSALIND HAYNES
Entity type:Individual
Prefix:
First Name:ROSALIND
Middle Name:HAYNES
Last Name:SHAVERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2239 BAYWOOD TREE LN
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-3086
Mailing Address - Country:US
Mailing Address - Phone:678-656-4333
Mailing Address - Fax:
Practice Address - Street 1:2239 BAYWOOD TREE LN
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3086
Practice Address - Country:US
Practice Address - Phone:678-656-4333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)