Provider Demographics
NPI:1831212547
Name:SHANKARNARAYAN, SAIKIRAN (MD)
Entity type:Individual
Prefix:
First Name:SAIKIRAN
Middle Name:
Last Name:SHANKARNARAYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 PAMPLICO HWY
Mailing Address - Street 2:SUITE A-315
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6019
Mailing Address - Country:US
Mailing Address - Phone:843-679-4260
Mailing Address - Fax:843-679-4264
Practice Address - Street 1:805 PAMPLICO HWY
Practice Address - Street 2:SUITE A-315
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6019
Practice Address - Country:US
Practice Address - Phone:843-679-4260
Practice Address - Fax:843-679-4264
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL 27200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine