Individual
LEDY P CHESTNUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
945 82ND PKWY, MYRTLE BEACH, SC 29572-4612
(843) 497-5929
(866) 778-9068
Mailing address
PO BOX 3439, NORTH MYRTLE BEACH, SC 29582-0439
(843) 839-4447
(843) 399-0123
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2295
SC
363AM0700X
Medical Physician Assistant
2295
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2102PA
—
SC
Enumeration date
07/02/2012
Last updated
07/28/2023
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