Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 36367 | SC |
NPI | 1033365762 |
---|---|
Provider Name | Dr. Shilpa Begur Shivakumar |
First Address | Atlanta, GA 30384-2145 |
Second Address | Columbia, SC 29203-6863 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2008 |
Last Update Date | 23/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
363671 | (05) | SC |