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Individual

DR. SHAWN A BIRCHENOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
391 SERPENTINE DR, SUITE 250, SPARTANBURG, SC 29303-3096
(864) 560-6717
(864) 560-7105
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
31645
SC
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
31645
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
316456
SC
05
5918104
NC
Enumeration date
05/11/2007
Last updated
11/30/2020
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