Individual
DR. JUDY A SHILLITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
631 JOHNNIE DODDS BLVD, MT PLEASANT, SC 29464-3030
(843) 881-0815
(843) 881-0743
Mailing address
1818 HENDERSON ST, COLUMBIA, SC 29201-2647
(803) 758-2600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13527
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135277
—
SC
Enumeration date
04/28/2006
Last updated
09/16/2009
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