Individual
MADISON SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3209 COLONIAL DR, COLUMBIA, SC 29203-6930
(803) 434-7399
Mailing address
3209 COLONIAL DR, COLUMBIA, SC 29203-6930
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LL95001
SC
Other
Enumeration date
04/01/2025
Last updated
07/18/2025
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