Individual
ABIGAIL SUZANNA MUHLY STATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 PATEWOOD DR STE 130, GREENVILLE, SC 29615-6317
(864) 455-8988
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8617
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3830
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4567PA
—
SC
Enumeration date
08/21/2020
Last updated
03/04/2022
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