Provider Demographics
NPI:1518905082
Name:DREHER, ALBERT SHANE (DC)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:SHANE
Last Name:DREHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5348 HARTFORD CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-4122
Mailing Address - Country:US
Mailing Address - Phone:828-638-9990
Mailing Address - Fax:
Practice Address - Street 1:547 FOLLY RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-3007
Practice Address - Country:US
Practice Address - Phone:828-638-9990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24341111N00000X
NC4006111N00000X
SC3725111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC11869638Medicare PIN