Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 52489 | SC |
NPI | 1083900724 |
---|---|
Provider Name | Dr. Kevin Shultz |
First Address | Greer, SC 29650-5221 |
Second Address | Greer, SC 29650-5221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2011 |
Last Update Date | 01/02/2019 |