Individual
MR. MICAH TODD VASKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1871 SAVAGE RD, CHARLESTON, SC 29407-4726
(843) 766-6308
(866) 533-4473
Mailing address
1871 SAVAGE RD, CHARLESTON, SC 29407-4726
(843) 766-6308
(866) 533-4473
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MPA3687PA
SC
363A00000X
Physician Assistant
MPA3687PA
SC
Other
Enumeration date
09/16/2020
Last updated
10/11/2024
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