Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 1045 | SC |
NPI | 1154317097 |
---|---|
Provider Name | Mrs. Shanna Elizabeth Cowan |
First Address | Greenville, SC 29607-5865 |
Second Address | Greenville, SC 29607-5910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2005 |
Last Update Date | 08/07/2007 |