Individual
ANDREA GINA JOAQUIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 PATEWOOD DR STE B260, GREENVILLE, SC 29615-6328
(864) 454-2852
(864) 454-2899
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4281
SC
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5115PA
—
SC
Enumeration date
12/19/2021
Last updated
05/12/2023
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