Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Theodore William Shively, DO

Individual provider Family Medicine Physician · NPI 1780666461

Dr. Theodore William Shively, DO is a Family Practice in Novi, Michigan. Graduated from Philadelphia College of Osteopathic Medicine in 1978, 48 years ago. Practices with Primecare Urgent Care PLLC, a 5-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
48
Trained at
Philadelphia College of Osteopathic Medicine
Licensed in
MI
In the registry since
2005
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

39555 W 10 Mile Rd Ste 302
Novi, MI 48375-2950
Phone: (248) 426-7200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 5101007588 (MI)
Geriatric Medicine (Family Medicine) Physician Taxonomy 207QG0300X · Licence 5101007588 (MI)

Record details

NPI number1780666461
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedNovember 17, 2005
Last updated in NPPESDecember 13, 2011
Mailing address39555 W 10 Mile Rd, Suite 302, Novi, MI 48375-2950

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolPHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 1978 (48 years in practice)
Group practice Primecare Urgent Care Pllc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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