Provider Demographics
NPI:1780992388
Name:SHAVER, STEVEN JAMES (PHARM D)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JAMES
Last Name:SHAVER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 S PACHECO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-5458
Mailing Address - Country:US
Mailing Address - Phone:505-847-3556
Mailing Address - Fax:505-473-0842
Practice Address - Street 1:2110 S PACHECO ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-5458
Practice Address - Country:US
Practice Address - Phone:505-507-4910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00006830183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist