Healthcare Provider Details

I. General information

NPI: 1033210505
Provider Name (Legal Business Name): SHARVETTE SLAUGHTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 11/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3973 RIVERS AVE
CHARLESTON SC
29405-7058
US

IV. Provider business mailing address

51 NASSAU STREET
CHARLESTON SC
29403
US

V. Phone/Fax

Practice location:
  • Phone: 843-747-8893
  • Fax: 843-747-8895
Mailing address:
  • Phone: 843-722-4112
  • Fax: 843-722-4802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20240
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: