Individual
MEREDITH BARB BAUERBAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2180 HENRY TECKLENBURG DR, CHARLESTON, SC 29414
(865) 647-5800
(865) 647-5979
Mailing address
2180 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-5798
(865) 647-5800
(865) 647-5979
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3301
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q030074
—
TN
Enumeration date
05/26/2017
Last updated
10/21/2019
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