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Individual

MRS. LAURA B KAISER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
BEAUFORT MEMORIAL SURGICAL SPECIALISTS, 1680 RIBAUT RD, PORT ROYAL, SC 29935-2008
(843) 524-8171
(844) 296-2307
Mailing address
955 RIBAUT RD, BMAC CREDENTIALING, BEAUFORT, SC 29902-5441
(843) 522-5674
(843) 522-5678

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2290
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3783PA
SC
01
PA2290
STATE LICENSE BOARD
SC
Enumeration date
03/23/2015
Last updated
03/28/2019
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