Healthcare Provider Details

I. General information

NPI: 1912560277
Provider Name (Legal Business Name): SHAREE KNOX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2019
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2566 ASHLEY RIVER RD
CHARLESTON SC
29414-4605
US

IV. Provider business mailing address

2566 ASHLEY RIVER RD
CHARLESTON SC
29414-4605
US

V. Phone/Fax

Practice location:
  • Phone: 843-571-6567
  • Fax:
Mailing address:
  • Phone: 843-571-6567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3379
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: