Provider Demographics
NPI:1316966278
Name:SHRUM, KARA JP (MD)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:JP
Last Name:SHRUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:JOY
Other - Last Name:PFENNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2000 E GREENVILLE ST
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1580
Mailing Address - Country:US
Mailing Address - Phone:864-512-7500
Mailing Address - Fax:864-512-7575
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:SUITE 2200
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-512-7500
Practice Address - Fax:864-512-7575
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL29194207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC291945Medicaid
SCP01623471OtherRR MEDICARE
SCAA60847111Medicare PIN