Individual
DR. KEITH D SHEALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1025 W MEETING ST, SUITE 200, LANCASTER, SC 29720-2204
(803) 285-7414
(803) 283-4329
Mailing address
1025 W MEETING ST STE 200, LANCASTER, SC 29720-2246
(803) 285-7414
(803) 283-4329
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10924
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109242
—
SC
05
—
GP0641
—
SC
Enumeration date
09/09/2005
Last updated
10/10/2023
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