Individual
ASHLEY NICOLE STARODUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3885 W ASHLEY CIR STE F600, CHARLESTON, SC 29414-9273
(843) 402-1360
(843) 402-3309
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2226
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2909PA
—
SC
Enumeration date
02/04/2015
Last updated
08/19/2021
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