Individual
MOLLY ANN MABRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
808 FARRAR DRIVE, CONWAY, SC 29526-8747
(843) 234-8700
(843) 234-8689
Mailing address
300 SINGLETON RIDGE RD, ATTENTION PNS CREDENTIALING, CONWAY, SC 29526-9142
(843) 234-6946
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5122
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6595PA
—
SC
Enumeration date
10/19/2023
Last updated
08/28/2025
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