Provider Demographics
NPI:1215341078
Name:HEMINGWAY, SHAUNA ELYSE (MD)
Entity type:Individual
Prefix:MRS
First Name:SHAUNA
Middle Name:ELYSE
Last Name:HEMINGWAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:SHAUNA
Other - Middle Name:ELYSE
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:169 ASHLEY AVE
Mailing Address - Street 2:MSC333
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425-8905
Mailing Address - Country:US
Mailing Address - Phone:843-260-0212
Mailing Address - Fax:
Practice Address - Street 1:169 ASHLEY AVE
Practice Address - Street 2:MSC333
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-8905
Practice Address - Country:US
Practice Address - Phone:843-260-0212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37097207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology