Provider Demographics
NPI:1811284649
Name:SHOOK, DAVID T (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:T
Last Name:SHOOK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 INDEPENDENCE POINTE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4536
Mailing Address - Country:US
Mailing Address - Phone:864-797-6174
Mailing Address - Fax:
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:SUITE 3700
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-512-1475
Practice Address - Fax:864-512-1390
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2018-05-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SCLL33753207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine