Individual
JEFFSHAN SAM JOSE JOHN PONNARASU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
316 2ND ST, CHERAW, SC 29520-2404
(843) 921-4851
Mailing address
709 MALL BLVD, SAVANNAH, GA 31406-4805
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5338
SC
Other
Enumeration date
01/16/2024
Last updated
07/11/2024
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