Individual
CHARLES MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
101 E WOOD ST, SUITE 401, SPARTANBURG, SC 29303-3040
(864) 560-6654
(864) 560-7388
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
A556
SC
363AM0700X
Medical Physician Assistant
Primary
A556
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0462PA
—
SC
01
—
196538
MEDCOST
SC
Enumeration date
04/20/2006
Last updated
02/05/2021
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