Provider Demographics
NPI:1487881785
Name:DINGER, SHAWNA MAE (PA-C)
Entity type:Individual
Prefix:MISS
First Name:SHAWNA
Middle Name:MAE
Last Name:DINGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 PARADISE CIR
Mailing Address - Street 2:
Mailing Address - City:TOWNVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29689-3428
Mailing Address - Country:US
Mailing Address - Phone:864-506-6080
Mailing Address - Fax:
Practice Address - Street 1:10630 CLEMSON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-4546
Practice Address - Country:US
Practice Address - Phone:864-482-6165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCTL1421363AS0400X
NC363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical