MEDICARE: FAITH MAYZECK SHULER APRN

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
1	363L00000X	Nurse Practitioner	29694	SC

General Provider Information

NPI Number	:	1528877958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAITH MAYZECK SHULER APRN

Provider Business Mailing Address
First Line	:	1401 SAM RITTENBERG BLVD STE 6
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-5031
Country	:	US
Telephone Number	:	843-973-5393
Fax Number	:	833-994-1098

Provider Business Practice Location Address
First Line	:	1401 SAM RITTENBERG BLVD STE 6
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-5031
Country	:	US
Telephone Number	:	843-973-5393
Fax Number	:	833-994-1098

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2024
Last Update Date	:	03/05/2026

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