Individual
TIMOTHY ANDREW STICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
102B OMNI DR, SENECA, SC 29672-9448
(864) 885-7971
(864) 885-7860
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
(864) 797-6198
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
282
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
282AN
PRESCRIPTIVE AUTHORITY
SC
Enumeration date
08/12/2007
Last updated
07/02/2015
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