Individual
CINDY L FIACCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
115 EXECUTIVE PKWY, MONCKS CORNER, SC 29461
(843) 761-2815
(843) 899-4723
Mailing address
201 SIGMA DR STE 100, SUMMERVILLE, SC 29486-7722
(843) 695-6071
(843) 569-5879
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
466
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1032PA
—
SC
Enumeration date
06/29/2006
Last updated
06/18/2018
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