Provider Demographics
NPI:1659026797
Name:SINGLETARY, SHAWN PHILIP (DPT)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:PHILIP
Last Name:SINGLETARY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 ISLAND PARK DR STE 105
Mailing Address - Street 2:
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-7560
Mailing Address - Country:US
Mailing Address - Phone:843-284-5200
Mailing Address - Fax:
Practice Address - Street 1:900 ISLAND PARK DR STE 105
Practice Address - Street 2:
Practice Address - City:DANIEL ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29492-7560
Practice Address - Country:US
Practice Address - Phone:843-284-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11125208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation