Healthcare Provider Details

I. General information

NPI: 1528877958
Provider Name (Legal Business Name): FAITH MAYZECK SHULER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2024
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 EDWARDS HALL
CLEMSON SC
29634-0001
US

IV. Provider business mailing address

1221 HARCOURT LN
CHARLESTON SC
29414-9063
US

V. Phone/Fax

Practice location:
  • Phone: 864-656-3076
  • Fax:
Mailing address:
  • Phone: 843-478-7544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number29694
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: