Black, Kristin Shannon

Black, Kristin Shannon is an individual health care provider with primary practice located at 820 W Meeting St , Lancaster SC 29720-2202. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Black, Kristin Shannon can be contacted via phone (803) 285-5441.

Contact Information

Primary practice address
820 W Meeting St Lancaster SC 29720-2202
Phone: (803) 285-5441
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 9901115 North Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 22582 South Carolina

Profile Details

NPI number 1609872720
LBN Legal business name Black, Kristin Shannon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Sep 26th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609872720 NPPES
North Carolina MEDICAID 891330G

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