Healthcare Provider Details

I. General information

NPI: 1730718743
Provider Name (Legal Business Name): SHAYAN SINHA MAHAPATRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2020
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 UNIVERSITY PKWY
AIKEN SC
29801-6302
US

IV. Provider business mailing address

302 UNIVERSITY PKWY
AIKEN SC
29801-6302
US

V. Phone/Fax

Practice location:
  • Phone: 803-641-5000
  • Fax:
Mailing address:
  • Phone: 803-641-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMMD.89573
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: