Healthcare Provider Details

I. General information

NPI: 1831696178
Provider Name (Legal Business Name): SHAYNE RYAN CASWELL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E CHEVES ST
FLORENCE SC
29506-2617
US

IV. Provider business mailing address

800 E CHEVES ST STE 260
FLORENCE SC
29506-2652
US

V. Phone/Fax

Practice location:
  • Phone: 843-777-2000
  • Fax:
Mailing address:
  • Phone: 438-665-7941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0102208751
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number0102208751
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number82161
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number0102208751
License Number StateVA
# 5
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number82161
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: