| Shannon Marie Philipps, DO | |
| 
					1413 Highway 17 N, Surfside Beach, SC 29575-6012  | |
| (843) 347-8041 | |
| (843) 347-8042 | 
| Full Name | Shannon Marie Philipps | 
|---|---|
| Gender | Female | 
| Speciality | Family Medicine - Sports Medicine | 
| Location | 1413 Highway 17 N, Surfside Beach, South Carolina | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1215490776 | NPI | - | NPPES | 
| 935741 | Medicaid | SC | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | 93574 (South Carolina) | Primary | 
| Entity Name | Wellstar Medical Group Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Shannon Marie Philipps, DO 300 Singleton Ridge Rd, Attention Credentialing, Conway, SC 29526-9142 Ph: () -  | Shannon Marie Philipps, DO 1413 Highway 17 N, Surfside Beach, SC 29575-6012 Ph: (843) 347-8041  | 
Dr. Mary Kaye Favaro, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 1407 Southwood Dr, Surfside Beach, SC 29575 Phone: 843-215-6992 Fax: 843-215-9409  | |
Dr. Dan Muntean, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1413 Highway 17 N, Surfside Beach, SC 29575 Phone: 843-238-5654 Fax: 843-238-1624  | |
Dr. Mark A Gauthier, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1600 Highway 17 N, Surfside Beach, SC 29575 Phone: 843-238-1461 Fax: 843-828-0622  | |
Mr. James Marvin Vest, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1413 Highway 17 N, Surfside Beach, SC 29575 Phone: 843-238-5654 Fax: 843-238-1624  | |
Dr. James C Hughes Iii, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1600 Highway 17 N, Surfside Beach, SC 29575 Phone: 843-238-1461 Fax: 843-828-0622  |