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Individual

DR. SHAWN KARL MATHIAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
2 INNOVATION DR, SUITE 400, GREENVILLE, SC 29607-5261
(864) 235-7665
(864) 233-5971
Mailing address
2 INNOVATION DR, SUITE 400, GREENVILLE, SC 29607-5261
(864) 235-7665
(864) 233-5971

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5462
NE
207RC0000X
Cardiovascular Disease Physician
Primary
34623
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
346236
SC
05
GP0975
SC
05
GP4697
SC
Enumeration date
05/14/2007
Last updated
05/21/2015
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