Individual
ANN MARGARET SHALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
390 KEOWEE SCHOOL RD, SENECA, SC 29672-6743
(864) 885-7129
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27335
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144092
CIGNA ID
SC
05
—
273359
—
SC
01
—
4123835
AETNA ID
SC
01
—
576007863057
BLUECHOICE HEALTHPLAN ID
SC
01
—
576007863095
BCBS OF SC ID
SC
01
—
P00160236
RR MEDICARE
SC
Enumeration date
05/15/2006
Last updated
08/28/2014
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