Individual
KEVIN W SHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
920 DOUG WHITE DR STE 250, MYRTLE BEACH, SC 29572-4181
(843) 236-1950
(843) 236-1952
Mailing address
920 DOUG WHITE DR STE 250, MYRTLE BEACH, SC 29572-4181
(843) 236-1950
(843) 236-1952
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
18455
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184552
—
SC
01
—
440001329
RAILROAD MEDICARE
SC
05
—
790646C
—
NC
Enumeration date
06/12/2006
Last updated
02/01/2022
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