Conrad, Shannon M

Conrad, Shannon M is an individual health care provider with primary practice located at 5070 International Blvd Ste 131 , N Charleston SC 29418-6007. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Conrad, Shannon M can be contacted via phone (843) 402-2995.

Contact Information

Primary practice address
5070 International Blvd Ste 131 N Charleston SC 29418-6007
Fax: (843) 402-3495
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 1538 South Carolina

Profile Details

NPI number 1659338226
LBN Legal business name Conrad, Shannon M
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2006
Last updated Oct 15th, 2021 - about 4 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 1659338226 NPPES
South Carolina MEDICAID 015389

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