Individual
GABRIELLE JOHNSTON SHEBIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-9444
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-07028
NC
363A00000X
Physician Assistant
Primary
4007
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154738672
—
NC
Enumeration date
07/16/2014
Last updated
01/20/2022
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