C Brent Shealy MD

NPI 1861467235 - Specialist - 174400000X

NPI Details
NPI 1861467235
Gender Male
Enumeration Date 02/21/2006
Last Updated 01/24/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
121 PARK CENTRAL DR
200
COLUMBIA SC, 29203-6469, US
Phone (803) 252-9907
Fax (803) 252-9906
Business Location
121 PARK CENTRAL DR
200
COLUMBIA SC, 29203-6469, US
Phone (803) 252-9907
Fax (803) 252-9906
Toxanomy
Taxonomy Code 174400000X
License State South Carolina
License Number 23581
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According to our database, Dr. C Brent Shealy MD NPI is 1861467235, taxonomy code is 174400000X and license number is 23581, license state is located at South Carolina. C Brent Shealy MD physically located at 121 Park Central Dr, Columbia SC, 29203-6469. NPI Number C Brent Shealy MD has the Individual type.

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1861467235 NPI number is provided on an as is basis without warranty of any kind. 1861467235 is maintained by the National Plan & Provider Enumeration System. The contents of C Brent Shealy MD are for informational purposes only.