Individual
DR. CHRISTOPHER TRAVIS SHADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2435 FOREST DR, COLUMBIA, SC 29204-2026
(803) 256-5300
Mailing address
2435 FOREST DR, COLUMBIA, SC 29204-2026
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34.013445
OH
207R00000X
Internal Medicine Physician
5101021834
MI
207R00000X
Internal Medicine Physician
Primary
DO52105
SC
Other
Enumeration date
06/25/2015
Last updated
08/17/2020
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