Organization
SHILAND FAMILY MEDICINE
Active
Parent organization
SHILAND FAMILY MEDICINE
Other names
Shiland Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHILAND FAMILY MEDICINE
Authorized official
SCOTT RISSMILLER (ENTERPRISE EVP)
(704) 355-8675
Entity
Organization
Contact information
Practice address
1656 RIVERCHASE BLVD, SUITE 2400, ROCK HILL, SC 29732-2084
(803) 329-5131
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
(704) 631-0002
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
07/05/2006
Last updated
01/05/2022
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