Individual
MADISON MORIN SHIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
125 DOUGHTY ST STE 660, CHARLESTON, SC 29403-5731
(843) 577-7550
(843) 853-5588
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2203
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2047PA
—
SC
Enumeration date
09/26/2014
Last updated
12/10/2021
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