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NPI Code Detail

MEDICARE: DR. KEVIN Q SHALKHAM MD

MEDICARE: DR. KEVIN Q SHALKHAM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician28849SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184710881
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN Q SHALKHAM MD
Provider Business Mailing Address
First Line : PO BOX 6069
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29171-6069
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5535 PLATT SPRINGS RD
Second Line :
City : LEXINGTON
State : SC
Zip : 29073-7519
Country : US
Telephone Number : 803-951-1880
Fax Number : 803-951-0384
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 11/11/2020

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Directions to “ DR. KEVIN Q SHALKHAM MD” Practice Location

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