Provider Demographics
NPI:1700868403
Name:SHRIDE, MICHAEL CURTIS (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CURTIS
Last Name:SHRIDE
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 1:1318 HAYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4992
Mailing Address - Country:US
Mailing Address - Phone:864-268-3400
Mailing Address - Fax:864-268-4526
Practice Address - Street 1:1318 HAYWOOD RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-2296
Practice Address - Country:US
Practice Address - Phone:864-268-3400
Practice Address - Fax:864-268-4526
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1670111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH1670Medicaid
SCCH1670Medicaid