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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

PORTERESHICE SHUNTA BRABHAM

Active Sole Proprietor

PORTERESHICE SHUNTA BRABHAM is a Health Maintenance Organization healthcare provider located in FAIRFAX, South Carolina. NPI 1528309606 is currently active in the NPPES registry. Verify at CMS.

Health Maintenance Organization · FAIRFAX, SC

Registration Details

NPI Number
1528309606
Provider Type
Individual
Gender
Female
NPI Issued
Mar 14, 2013 (13.454016884174 yrs)
Last Updated
Mar 14, 2013
Sole Proprietor
Yes

Practice Information

Address
345 AMELIA ST
FAIRFAX, SC, 298275967
Browse SC providers · Browse ZIP 29827
Phone
8036827110
Primary Specialty
Health Maintenance Organization
302R00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.