Individual
ANNA GRACE STODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
989 RIBAUT RD STE 360, BEAUFORT, SC 29902-5427
(843) 524-8171
Mailing address
804 PINCKNEY ST, BEAUFORT, SC 29902-4746
(843) 441-1359
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3560
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400676
—
SC
Enumeration date
04/26/2020
Last updated
04/26/2020
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