Individual
MANISHA CHANDRAKANT SHANBHAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 PATEWOOD DR STE A200, GREENVILLE, SC 29615-3580
(864) 454-5120
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34098
SC
207RA0002X
Adult Congenital Heart Disease Physician
Primary
34098
SC
2080P0202X
Pediatric Cardiology Physician
34098
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340982
—
SC
Enumeration date
12/29/2006
Last updated
12/06/2022
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