Individual
SHANNON MCQUILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-8905
(847) 287-8284
Mailing address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-8905
(847) 287-8284
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LL94416
SC
2085R0202X
Diagnostic Radiology Physician
LL94416
SC
Other
Enumeration date
05/27/2025
Last updated
05/27/2025
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