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General NPI Number Information
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NPI Number | 1306929799
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Entity Type | Individual
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Provider Name | CLAYTON JOEL SHAMBLIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 727 SE MAIN ST STE 120
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-3248
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Country | US
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Telephone | 864-454-6700
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Fax | 864-454-6705
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Provider Business Mailing Address
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Address Line | 300 E MCBEE AVE FL 4
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City | GREENVILLE
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State | SC
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Zip | 29601-2842
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Country | US
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Telephone | 864-522-8603
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 29001
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 29001
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License Number State | SC
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