Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | 36296 | SC |
Y | 207R00000X | Internist | 36296 | SC |
Y | 111NI0900X | Internist | 36296 | SC |
N | 207RH0002X | Hospice and Palliative Medicine | 36296 | SC |
NPI | 1306850656 |
---|---|
Provider Name | Dr. Marie-Florence Shadlen |
First Address | Summerville, SC 29483-6122 |
Second Address | Summerville, SC 29483-6097 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2006 |
Last Update Date | 17/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
362967 | (05) | SC |