Individual
ERIC E SHOUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8 RICHLAND MEDICAL PARK DR STE 100, COLUMBIA, SC 29203-8006
(803) 434-3800
(803) 744-2759
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
744
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035PA
—
SC
Enumeration date
04/11/2006
Last updated
06/25/2021
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