Individual
SHAN FU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2376 CYPRESS CIR, SUITE 300, CONWAY, SC 29526-8964
(843) 347-7222
(843) 347-3305
Mailing address
210 VILLAGE CENTER BLVD STE 140, MYRTLE BEACH, SC 29579-6706
(843) 353-3460
(843) 353-3461
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
TL 1641
SC
Other
Enumeration date
04/27/2011
Last updated
07/20/2022
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