Individual
MRS. SUSAN MARIE KAMINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1113 CHURCH ST, CONWAY, SC 29526-4128
(843) 248-6269
(843) 248-0535
Mailing address
PO BOX 749306, ATLANTA, GA 30374-9306
(843) 248-6269
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3312
SC
363A00000X
Physician Assistant
MA 002171-L
PA
363AM0700X
Medical Physician Assistant
Primary
3312
SC
Other
Enumeration date
02/27/2007
Last updated
11/03/2024
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