Individual
MARLON D SHELBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
517 DOCTORS CT, CHESTER, SC 29706-8644
(803) 581-2800
(803) 581-4396
Mailing address
PO BOX 603898, CHARLOTTE, NC 28260-3898
(803) 581-2800
(803) 581-4396
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
608
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104247
—
SC
Enumeration date
12/18/2006
Last updated
05/13/2019
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