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NPI Code Detail

MEDICARE: SHELIA FANKHAUSER MD

MEDICARE: SHELIA FANKHAUSER 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
1208D00000XGeneral Practice Physician12385SC

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 : 1295895977
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELIA FANKHAUSER MD
Provider Business Mailing Address
First Line : 2347 HWY 17 BUSINESS SOUTH
Second Line :
City : GARDEN CITY
State : SC
Zip : 29576-7611
Country : US
Telephone Number : 843-357-2443
Fax Number : 843-357-2132
Provider Business Practice Location Address
First Line : 2347 HWY 17 BUS S
Second Line :
City : GARDEN CITY
State : SC
Zip : 29576-7611
Country : US
Telephone Number : 843-357-2443
Fax Number : 843-357-2132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 10/31/2008

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Directions to “ SHELIA FANKHAUSER MD” Practice Location

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