Individual
MISTY A SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7 INDEPENDENCE PT STE 300, GREENVILLE, SC 29615-4569
(864) 522-3700
(864) 522-3705
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
88438
SC
207LP3000X
Pediatric Anesthesiology Physician
Primary
88438
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
884387
—
SC
Enumeration date
05/17/2017
Last updated
12/21/2022
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