Individual
ROSAMOND B BENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9995 MILES JAMISON ROAD, SUMMERVILLE, SC 29485-8403
(843) 821-5823
(843) 821-5859
Mailing address
1500 ASHLEY GARDEN BLVD, CHARLESTON, SC 29414-9127
(843) 821-5888
(843) 821-5859
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
975
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1064178
NCCPA
SC
01
—
975
PA LICENSE NUMBER
SC
01
—
A975FP
PRESCRIPTIVE AUTHORITY
SC
Enumeration date
05/16/2006
Last updated
08/13/2007
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