Individual
DR. SHANNON M CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
5070 INTERNATIONAL BLVD STE 131, N CHARLESTON, SC 29418-6007
(843) 402-2995
(843) 402-3495
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1538
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015389
—
SC
Enumeration date
04/27/2006
Last updated
10/15/2021
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