Individual
SHEELAH GERVACIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
109 PHYSICIANS DRIVE, SUITE A, GREER, SC 29650
(864) 797-9150
(864) 797-9155
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38393
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
383935
—
SC
Enumeration date
07/17/2015
Last updated
05/25/2021
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