Individual
ALYSSA HOWARD GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2880 TRICOM ST, NORTH CHARLESTON, SC 29406-9171
(843) 797-5050
(843) 797-3633
Mailing address
2880 TRICOM ST, NORTH CHARLESTON, SC 29406-9171
(843) 797-5050
(843) 797-3633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2440
SC
363AM0700X
Medical Physician Assistant
Primary
2440
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902246077
ARCIS HEALTHCARE, LLC GROUP NPI
SC
01
—
D043
ARCIS HEALTHCARE, LLC GROUP MEDICARE PTAN
SC
01
—
GP6337
ARCIS HEALTHCARE, LLC GROUP MEDICAID NO.
SC
Enumeration date
01/13/2016
Last updated
03/13/2020
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