Portereshice Shunta Brabham
Portereshice Shunta Brabham is a Health Maintenance Organization in Fairfax, South Carolina. Practices as a sole proprietor. Registered with an NPI since 2013.
- In the registry since
- 2013
Practice location Address checks out
345 Amelia StFairfax, SC 29827-5967
Phone: (803) 682-7110
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Health Maintenance Organization (primary) | Taxonomy 302R00000X |
|---|
Record details
| NPI number | 1528309606 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | March 14, 2013 |
| Last updated in NPPES | March 14, 2013 |