Individual
DR. JEFFREY KEITH SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1241 WOODLAND AVENUE, MOUNT PLEASANT, SC 29464
(843) 824-0606
(843) 824-0909
Mailing address
1241 WOODLAND AVENUE, MOUNT PLEASANT, SC 29464
(843) 824-0606
(843) 824-0909
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
21549
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215494
—
SC
01
—
300128417
MEDICARE RR
—
Enumeration date
05/13/2006
Last updated
07/14/2008
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