Individual
MR. EUGENE ANCRUM II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
8720 DORCHESTER RD, NORTH CHARLESTON, SC 29420-7303
(843) 789-1620
Mailing address
8720 DORCHESTER RD, NORTH CHARLESTON, SC 29420-7303
(843) 789-1620
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2439
SC
363AM0700X
Medical Physician Assistant
2439
SC
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2431PA
—
SC
Enumeration date
07/16/2015
Last updated
04/09/2026
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