Provider Demographics
NPI:1912931007
Name:PRICE, BETH SHILEPSKY (MD)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:SHILEPSKY
Last Name:PRICE
Suffix:
Gender:F
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:PO BOX 751461
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1461
Mailing Address - Country:US
Mailing Address - Phone:843-792-6200
Mailing Address - Fax:
Practice Address - Street 1:171 ASHLEY AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-5013
Practice Address - Country:US
Practice Address - Phone:843-792-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24817207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC248173Medicaid
SCAA43675281Medicare PIN
SCAA59825277Medicare PIN
SCAA08576834Medicare PIN
SCI29566Medicare UPIN
SCAA08577522Medicare PIN
SCAA08578798Medicare PIN
SCAA59825282Medicare PIN
SCAA59827498Medicare PIN
SCAA59827499Medicare PIN
SCAA08576868Medicare PIN
SCAA43678798Medicare PIN
SC248173Medicaid
SCAA62127126Medicare PIN
SCAA66857555Medicare PIN
SCAA08576882Medicare PIN
SCAA59827006Medicare PIN