Provider Demographics
NPI:1215199575
Name:CALLOWAY, SHON MARIE (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:SHON
Middle Name:MARIE
Last Name:CALLOWAY
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 BELLRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-3077
Mailing Address - Country:US
Mailing Address - Phone:803-329-4582
Mailing Address - Fax:
Practice Address - Street 1:1518 BELLRIDGE RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3077
Practice Address - Country:US
Practice Address - Phone:803-329-4582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC875130133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered