Shaffer, Kelly Elaine

Shaffer, Kelly Elaine is an individual health care provider with primary practice located at 2687 Lake Park Dr , North Charleston SC 29406-9100. She recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as her primary health care specialty. Shaffer, Kelly Elaine can be contacted via phone (843) 572-1010.

Contact Information

Primary practice address
2687 Lake Park Dr North Charleston SC 29406-9100
Phone: (843) 572-1010
Fax: (843) 569-1719
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 2008-02041 North Carolina
Allopathic & Osteopathic Physicians / Urology 208800000X LL28461 South Carolina

Profile Details

NPI number 1710060017
LBN Legal business name Shaffer, Kelly Elaine
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2006
Last updated Feb 17th, 2017 - about 7 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 1710060017 NPPES
South Carolina Other 28461 SC MEDICAL LICENSE
South Carolina Other 273905550 SC MEDICAL LICENSE

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