Individual
DR. SHAWN MICHAEL IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 PALMETTO HEALTH PKWY STE 350, COLUMBIA, SC 29212-1756
(803) 434-2020
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(803) 296-7320
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
37699
SC
207WX0120X
Cornea and External Diseases Specialist Physician
Primary
37699
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376998
—
SC
Enumeration date
05/28/2014
Last updated
10/20/2022
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