Individual
RUPA RAVINDRA SHETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
237 AVENUE OF THE PALMS, MYRTLE BEACH, SC 29579-1247
(843) 461-6133
(843) 347-6907
Mailing address
237 AVENUE OF THE PALMS, MYRTLE BEACH, SC 29579-1247
(843) 461-6133
(843) 347-6907
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
27604
SC
2084P0804X
Child & Adolescent Psychiatry Physician
27604
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1516445
—
SC
Enumeration date
07/13/2006
Last updated
06/02/2016
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