Individual
JONATHAN DANIEL SHOULTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
890 W FARIS RD, SUITE 330, GREENVILLE, SC 29605-4253
(864) 455-1270
(864) 233-1204
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
32632
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
326329
—
SC
Enumeration date
06/02/2010
Last updated
05/12/2021
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