Individual
SHELLEY S CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(703) 989-0471
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
3351
SC
363AS0400X
Surgical Physician Assistant
PA3351
SC
Other
Enumeration date
07/31/2019
Last updated
10/21/2020
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