Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 34200 | SC |
NPI | 1003825944 |
---|---|
Provider Name | Rhett Mckey Shirley |
First Address | Greenville, SC 29601-2842 |
Second Address | Greenville, SC 29605-4253 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 12/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
342007 | (05) | SC |
P01005778 | RAILROAD MEDICARE (01) | SC |