Individual
GREGORY R PFENINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
316 CALHOUN ST, CHARLESTON, SC 29401-1113
(843) 724-2450
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2032
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124508400
DEPT OF LABOR WORK COMP
—
05
—
1840PA
—
SC
01
—
198177
FEDERAL BLACK LUNG
—
01
—
P00178506
RAILROAD MEDICARE
—
01
—
Q22014
CARELINK
—
01
—
WV322
THE HEALTH PLAN
—
Enumeration date
03/15/2006
Last updated
05/11/2021
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