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Individual

MARIAH JORDAN SVANTESSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
851 LEONARD FULGHUM DR STE 101, MOUNT PLEASANT, SC 29464-3793
(843) 971-9350
(843) 971-9351
Mailing address
851 LEONARD FULGHUM DR STE 101, MOUNT PLEASANT, SC 29464-3793
(843) 971-9350
(843) 971-9351

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
3098
SC
363A00000X
Physician Assistant
Primary
PA.0006527
CO
363AS0400X
Surgical Physician Assistant
3098
SC

Other

Enumeration date
10/30/2018
Last updated
02/01/2023
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