Provider Demographics
NPI:1871595199
Name:SHIRLEY, DAVID WILLIAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAM
Last Name:SHIRLEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1656 SULGRAVE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5933
Mailing Address - Country:US
Mailing Address - Phone:843-556-0284
Mailing Address - Fax:843-556-0284
Practice Address - Street 1:531 WAPPOO RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-2223
Practice Address - Country:US
Practice Address - Phone:843-556-1994
Practice Address - Fax:843-556-1991
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10519183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist