Individual
CHELSEA LEROUX BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1228 HARDEN ST STE C, COLUMBIA, SC 29204-1800
(803) 748-1181
(803) 748-1185
Mailing address
169 LAURELHURST AVE, COLUMBIA, SC 29210-3825
(803) 733-5969
(803) 753-5591
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2414
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2398PA
—
SC
01
—
P01671701
RR MEDICARE
SC
Enumeration date
09/18/2015
Last updated
04/19/2023
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