Individual
SHAQUAN NICOLE LYDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
907 FOLLY RD, CHARLESTON, SC 29412-3919
(843) 795-5452
Mailing address
907 FOLLY RD, CHARLESTON, SC 29412-3919
(843) 795-5452
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
42239
SC
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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