Individual
JOHNATHAN MARK SEBRING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2000
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
96993
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
19520
SC
Other
Enumeration date
04/18/2014
Last updated
11/11/2020
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