1. Curriculum Vitae
of
THEODORE WILLIAM SHIVELY, DO, MHSAd
HOME
41693 Chesterfield CT.
Novi, MI48375
(248) 449-8226
Fax: 248-449-8227
OFFICE
PrimeCare of Novi, PLLC
39555 West Ten Mile Road
Suite #302
Novi, MI48375
OBJECTIVE
To be a good steward: to use my talents wisely and to their fullest for the betterment of all.
I strive to make the best possible use of my clinical and teaching skills and use myenergy, academic research,
clinical and leadership interests for the betterment of all organizations with which I become affiliated.
CLINICAL BACKGROUND
July 2011 – Present Appointed Unites States Aviation Medical Examiner, Federal Aviation Administration
July 2010 - Present Appointed United States Civil Surgeon
July 2009 – Present Hospitalist, ProvidenceHospital and MedicalCenters, Southfield, MI
July 2003 – June 2005 Osteopathic Program Director – Family Practice, ProvidenceHospital
andMedicalCenters, Southfield, MI
October 2003 – Assistant Clinical Professor, MichiganStateUniversity
Present College of Osteopathic Medicine
October 2003 – Assistant Clinical Professor, WayneStateUniversityCollege of Medicine
Present
January 2005 – President, Department of Family Medicine, ProvidenceHospital and
January 2008 MedicalCenters, Southfield, MI
January 2003 – Secretary, Department of Family Practice, ProvidenceHospital and Medical January
2005 Centers, Southfield, MI
April 2003 –Present Staff Physician, Angela Hospice, Livonia, Michigan
October 8, 2000 – Co-founder, PrimeCare of Novi, a multi-physician family practice in Novi, MI
Present

2. June. 1997 – Moonlighting work- ProvidenceHospital and. Medical Centers.
October 6. 2000 Urgent Care Physician
November 2001- Clinical faculty, Department of Family Medicine, Botsford GeneralHospital,
Present Farmington Hills, MI. Duties involve teaching and precepting Family Practice
and Internal Medicine residents.
January -1997 – Private (employed) group practice. Specialist in Family -Practice,
October 8,, 2000 ProvidenceHospital and Medical Centers
47601 Grand River Avenue, Suite C-106
Novi, MI48374
Memberships: Managed Care, Quality Assurance, Medical Practice
Management Group (Electronic medical records)
October, 1998 – Lecturer, MichiganState Medical Society. Adult Immunization
March, 1999 State representative to national ACP/NIH convention on immunization policies and
practices.
February, 1996 – Faculty, Family Practice Residency. Mission Health, Southfield, Mi.
February, 1997 Duties involve in-patient and out-patient teaching, of residents.
in-patient and out-patient clinical care. "Teacher of the Year"
awarded by the residents. June 1996, "Outstanding Faculty of the Year"
awarded by the Department of Family Practice, June 1996.
Committee memberships: Patient Education, Geriatrics-, Physician Compensation and
Benefits, Primary Care Council. I was responsible for the Geriatrics teaching component
of the Family Practice Residency.
July 1. 1981 – Extensive clinical experience in primary rural health care. Continuous
Fe6ary, 1996 self-employed, self-administered private medical practice in Cassville,
Pennsylvania (Pop. 300). The practice grew to the point where I had
to restrict new patients in 1988. At that time, there were 7000 active patients.
From 1992 through 1994, 1 employed a second physician.
Cassville is located 17 miles south into the mountains from the
Mixed staff 110 bed community hospital. Active staff privileges
atJ.C.BlairHospital included nursery, ICU, pediatrics, medicine and the
Emergency Room. Committee members*: P&T, QC, credentials, medical records and ICU.
July 1, 1979 – National Health Service Corps physician, BroadtopMedicalCenter, Broadtop
June 30., 1981 PA. This was a community-board administered general practice. Hospital
privileges were maintained as above.
EDUCATION
December, 1997 Master of Science, Concentration in Health Science Administration
CentralMichiganUniversity
July 1,1978– Rotating internship, Detroit Osteopathic Hospital Corporation
June 30, 1979 Detroit, Michigan.
July 1, 1974 – MedicalSchool, PhiladelphiaCollege of Osteopathic Medicine
June 30, 1978 Philadelphia, Pennsylvania. Doctor of Osteopathy granted
June 4, 1978.
September 1970 – College, LehighUniversity~ Bethlehem, Pennsylvania. Granted
May 1974 B.S. in Fundamental Sciences. This program was designed
to accommodate students with double science majors.

3. September 1966 – High School , Salutatorian, BishopMcDevittHigh School,
May 1970 Harrisburg, Pennsylvania. Extra-curricular activities included
Honor Society, Drama Club, Latin Club, Yearbook (sports
editor), Projection Club, Forensics Club and Swimming Team
(Varsity letter 3 years).
LICENSURE
July 7, 1979 Unrestricted license to practice osteopathic medicine.
Granted by the State Board of Osteopathic Medical Examiners
of the Commonwealth of Pennsylvania, License # OS-004262-L.
August 2., 1979 Unrestricted license to practice osteopathic medicine.
Granted by the State Board of Osteopathic Medical Examiners
of the State of Michigan, License # B-7518. (Now 51017588)
CERTIFICATION
January 12, 1995 Recertified in Family Practice. This was a voluntary recertification
and was the first tune the Osteopathic profession sponsored such
an examination. Certificate # 3397.Expires December 31, 2005.
February 14, 1992 Certificate of Added Qualification in Geriatrics.Certificate # 3397.
July 28, 1988 Certified in General Practice by the American Osteopathic Board
of General Practitioners and Surgeons, Certificate # 3397.
July 1, 1979 Passed the National Board of Examiners for Osteopathic
Physicians and Surgeons., USA.Certificate # 5422.
MEMBERSHIPS
Professional American Osteopathic Association
AmericanCollege of General Practitioners
BotsfordHospital, Farmington, MI, Inactive medical staff
Michigan Osteopathic Association
Pennsylvania Osteopathic Medical Association
ProvidenceHospital and MedicalCenters, active medical staff
AWARDS AND APPOINTMENTS
Secretary, Department of Medicine, I C. BlairMemorialHospital
1986-1987
"Teacher of the Year" awarded by the residents, June 1996
"Outstanding Faculty of the Year" awarded by the
Department of Family Practice, June 1996
PERSONAL
Date of Birth August 15, 1952
Place of Birth Harrisburg, Pennsylvania
Marital Status Married
Race Caucasian
Citizenship USA
TEACHING AND RESEARCH

4. Teaching is what I do as a practicing physician! I have distilled over my career a unique style of analogy in order to
illustrate medical points to patients. I have extensive experience in public speaking to civic groups, ambulance corps,
religious and medical organizations.
1996-97 Responsible for the Geriatrics component of the Family Practice
Residency. Duties included weekly in-patient teaching rounds, regular
lectures on practice management and weekly lectures in the nursing
home on topics in geriatric medicine.
1982 Course Director, Emergency Medical Technician 1
1985 Course Director, Emergency Medical Technician 1
1987-1988 Clinical researcher, Loratadine Study, Schering Corporation
September 1987- Clinical researcher, Omeprazole open label study, MSD,
May 1990 This study involved setting up an IRB and compliance with
extensive study protocols for development of data ultimately
included in MSD`s data base. This was done for the benefit
of one of my patients with a MEN-l syndrome in order to
obtain the drug under the compassionate use program before
it was commercially available.
1989 Course director, EKG interpretation
May 199 1 -June 1992 Clinical researcher, Isradapine Study, Sandoz Corporation
June 1996 "Teacher of the Year". Department of Family Practice,
ProvidenceHospital and MedicalCenter.
Schwartzberg Award for teaching excellence, Family Practice.
November, 1997 Masters Thesis: MEDICARE RISK CONTRACTS: CASE STUDY
IN THEIR IMPLEMENTATION AND A PROSPECTIVE COST
BENEFIT ANALYSIS FOR THE CREATION OF A CASE
MANAGEMENT POSITION
REFERENCES AND FURTHER DATA ON REQUEST