MEDICARE: DR. DAVID WILLIAM SHIRLEY PHARMD

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	183500000X	Pharmacist	10519	SC

General Provider Information

NPI Number	:	1871595199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID WILLIAM SHIRLEY PHARMD

Provider Business Mailing Address
First Line	:	1656 SULGRAVE RD
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-5933
Country	:	US
Telephone Number	:	843-556-0284
Fax Number	:	843-556-0284

Provider Business Practice Location Address
First Line	:	531 WAPPOO RD
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-2223
Country	:	US
Telephone Number	:	843-556-1994
Fax Number	:	843-556-1991

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	08/24/2009

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