Individual
MRS. AMY LYNN TROLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 577-5011
Mailing address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 577-5011
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50001943
OH
363AS0400X
Surgical Physician Assistant
020341
NY
363AS0400X
Surgical Physician Assistant
Primary
627
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0068585
MEDICAID
OH
01
—
1447371737
MEDICAL MUTUAL
OH
01
—
1632131
GATEWAY HEALTH
OH
01
—
270577733079
CARESOURCE
OH
01
—
610902
WELLCARE
OH
01
—
720614
ANTHEM
OH
01
—
779386/713428
BUCKEYE MEDICAID/MEDICARE
OH
01
—
9720708
AETNA
OH
01
—
H021220
MEDICARE
OH
01
—
P01238565
RAILROAD MEDICARE
OH
Enumeration date
04/03/2007
Last updated
03/24/2017
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