Healthcare Provider Details

I. General information

NPI: 1871925958
Provider Name (Legal Business Name): DR. MONICA SHEA CROMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2013
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 SOCIETY HILL DR
AIKEN SC
29803-1731
US

IV. Provider business mailing address

131 MALLARD LAKE DR
AIKEN SC
29803-7693
US

V. Phone/Fax

Practice location:
  • Phone: 803-226-0104
  • Fax:
Mailing address:
  • Phone: 803-443-4017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number12820
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number024893
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: