Dr Kelly Elaine Shaffer, MD | |
2687 Lake Park Dr, North Charleston, SC 29406-9100 | |
(843) 572-1010 | |
(843) 569-1719 |
Full Name | Dr Kelly Elaine Shaffer |
---|---|
Gender | Female |
Speciality | Urology |
Experience | 22 Years |
Location | 2687 Lake Park Dr, North Charleston, South Carolina |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710060017 | NPI | - | NPPES |
28461 | Other | SC | SC MEDICAL LICENSE |
273905550 | Other | NC | NC MED BOARD # 153519 |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | 2008-02041 (North Carolina) | Primary |
208800000X | Urology | LL28461 (South Carolina) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Trident Medical Center | Charleston, SC | Hospital |
Mount Pleasant Hospital | Mount pleasant, SC | Hospital |
East Cooper Medical Center | Mount pleasant, SC | Hospital |
Bon Secours-st Francis Xavier Hospital | Charleston, SC | Hospital |
Roper Hospital | Charleston, SC | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Lowcountry Urology Clinics, Pa | 6406869247 | 16 |
Entity Name | Lowcountry Urology Clinic,pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942242714 PECOS PAC ID: 6406869247 Enrollment ID: O20060724000104 |
Mailing Address | Practice Location Address |
---|---|
Dr Kelly Elaine Shaffer, MD 1300 Hospital Dr, Mount Pleasant, SC 29464-3261 Ph: (843) 884-9646 | Dr Kelly Elaine Shaffer, MD 2687 Lake Park Dr, North Charleston, SC 29406-9100 Ph: (843) 572-1010 |
Dr. Nelson Randolph Ploch, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2890 Tricom Street, North Charleston, SC 29406 Phone: 843-797-6600 Fax: 843-820-1440 | |
Dr. Samuel Walker Nickles, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2890 Tricom St, North Charleston, SC 29406 Phone: 843-797-6600 Fax: 843-820-1440 | |
Dr. Taylor B Vaughan, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 2890 Tricom St, North Charleston, SC 29406 Phone: 843-797-6600 Fax: 843-820-1440 | |
Dr. Frederick James Goulding, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 2890 Tricom Street, North Charleston, SC 29406 Phone: 843-797-6600 Fax: 843-820-1440 | |
Dr. Theodore Edward Brisson, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2890 Tricom Street, North Charleston, SC 29406 Phone: 843-797-6600 Fax: 843-820-1440 | |
Dr. Marshall Scott Wingo, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2687 Lake Park Dr, North Charleston, SC 29406 Phone: 843-572-1010 Fax: 843-569-1719 |