Individual
GABRIELLE ELAINA BULLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8120 ROURK ST, MYRTLE BEACH, SC 29572-4127
(843) 449-1438
Mailing address
8120 ROURK ST, MYRTLE BEACH, SC 29572-4127
(843) 449-1438
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5955
SC
Other
Enumeration date
08/04/2025
Last updated
05/05/2026
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