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Individual

MR. EDWARD WIKKIAM SHEPARD JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 789-7330
(843) 937-6110
Mailing address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 789-7330
(843) 937-6110

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
09/15/2006
Last updated
07/08/2007
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