Provider Demographics
NPI:1447204938
Name:SHAWINSKY, ARLENE ANN (MD)
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:ANN
Last Name:SHAWINSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:ANN
Other - Last Name:ROSENTHAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:776 DANIEL ELLIS DR
Mailing Address - Street 2:BLDG 2 STE A
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-3094
Mailing Address - Country:US
Mailing Address - Phone:843-795-8100
Mailing Address - Fax:843-573-2534
Practice Address - Street 1:776 DANIEL ELLIS DR
Practice Address - Street 2:BLDG 2 STE A
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-3094
Practice Address - Country:US
Practice Address - Phone:843-795-8100
Practice Address - Fax:843-573-2534
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18048208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC180486Medicaid
SC180486Medicaid