Individual
SHAUNDREAL DESERE'E JAMISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
517 MOYE BLVD, GREENVILLE, NC 27834-2849
(252) 744-2335
(252) 744-5035
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2016-01611
NC
208000000X
Pediatrics Physician
LL35737
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245677111
—
NC
01
—
19XAZ
BCBS OF NC
NC
01
—
NN20700322
MEDICARE
NC
Enumeration date
05/31/2013
Last updated
02/02/2026
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