Individual
PATRICIA N RAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
853 N CHURCH ST, SUITE 720C, SPARTANBURG, SC 29303-3098
(864) 560-6419
(864) 560-7498
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304-2168
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004742
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0622PA
—
SC
Enumeration date
07/18/2006
Last updated
03/19/2008
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