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Individual

MRS. SHELLEY M GILBERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPA-C

Contact information

Practice address
4301 DICK POND RD, MYRTLE BEACH, SC 29588-6807
(843) 652-8100
(843) 652-8122
Mailing address
PO BOX 1209, MURRELLS INLET, SC 29576-1209
(843) 652-8220
(843) 520-8365

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
013354
NY
363AM0700X
Medical Physician Assistant
Primary
TL2725

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03160950
NY
01
TL2725
SC MEDICAL LICENSE
SC
Enumeration date
12/18/2008
Last updated
04/06/2017
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