Individual
SHAKISHA T REDMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2605 KINARD ST, SUITE 200, NEWBERRY, SC 29108-2967
(803) 405-1900
(803) 405-1919
Mailing address
1818 HENDERSON ST, COLUMBIA, SC 29201-2619
(803) 276-2186
(803) 276-2630
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
A889
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1202PA
—
SC
Enumeration date
01/04/2007
Last updated
11/03/2016
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