Healthcare Provider Details

I. General information

NPI: 1184533358
Provider Name (Legal Business Name): MS. SHAMYRA COPELAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHAMURA GOODWIN MA

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7426 SUNVIEW DR
COLUMBIA SC
29209-2710
US

IV. Provider business mailing address

7426 SUNVIEW DR
COLUMBIA SC
29209-2710
US

V. Phone/Fax

Practice location:
  • Phone: 803-908-6003
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: