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Individual

TIMOTHY SCOTT SHAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3000 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-1442
(803) 395-2200
Mailing address
1338 SANFORD DR, COLUMBIA, SC 29206-4550
(803) 782-1330

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
23333
SC
207Q00000X
Family Medicine Physician
Primary
23333
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
233330
SC
Enumeration date
04/19/2006
Last updated
03/07/2023
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