Individual
DR. ANTHONY SHADIACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
920 DOUG WHITE DR STE 250, MYRTLE BEACH, SC 29572-4181
(843) 848-4640
(843) 839-2382
Mailing address
920 DOUG WHITE DR STE 250, MYRTLE BEACH, SC 29572-4181
(843) 848-4640
(843) 839-2382
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
82082
SC
207Q00000X
Family Medicine Physician
OS13394
FL
207QS0010X
Sports Medicine (Family Medicine) Physician
82082
SC
Other
Enumeration date
01/05/2012
Last updated
08/31/2022
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