Provider Demographics
NPI:1528022423
Name:GHENT, WILLIAM SHAWN (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SHAWN
Last Name:GHENT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SHAWN
Other - Middle Name:
Other - Last Name:GHENT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 6069
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-6069
Mailing Address - Country:US
Mailing Address - Phone:803-936-8900
Mailing Address - Fax:
Practice Address - Street 1:2728 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4840
Practice Address - Country:US
Practice Address - Phone:803-256-0464
Practice Address - Fax:803-935-8667
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14529207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC145293Medicaid
SCQ335010001Medicare PIN
SCF317789560Medicare PIN
SCF31778Medicare UPIN