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Individual

PETER WOLFGANG LEDWIN BEAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
27 GAMECOCK AVE STE 201, CHARLESTON, SC 29407-3398
(843) 769-8215
Mailing address
27 GAMECOCK AVE STE 201, CHARLESTON, SC 29407-3398

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-12167
NC
363A00000X
Physician Assistant
Primary
5118
SC

Other

Enumeration date
01/29/2021
Last updated
06/26/2024
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