Individual
SHREYA RAJESH SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 N 12TH ST, WEST COLUMBIA, SC 29169-6502
(803) 217-0415
Mailing address
621 LAKE FOREST RD, COLUMBIA, SC 29209-2579
(864) 202-3422
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4451
SC
Other
Enumeration date
06/02/2022
Last updated
06/14/2022
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