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Individual

DR. ANDREA DENISE BOAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C, PHD

Contact information

Practice address
12 COMMERCIAL ROW APT A, CHARLESTON, SC 29412-3641
(864) 506-2319
Mailing address
135 RUTLEDGE AVE # MSC561, CHARLESTON, SC 29425-8903
(843) 876-1064

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3679
SC

Other

Enumeration date
09/02/2020
Last updated
10/22/2020
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