Individual
SHUSHAN ELAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
125 COMMONWEALTH DR, GREENVILLE, SC 29615-4812
(864) 675-4000
Mailing address
125 COMMONWEALTH DR, GREENVILLE, SC 29615-4812
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
204137
SC
Other
Enumeration date
03/02/2011
Last updated
03/02/2011
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