Individual
GABRIELLE SAMIRATEDU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCMSC, PA-C
Contact information
Practice address
316 CALHOUN ST, CHARLESTON, SC 29401-1113
(843) 724-2000
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(888) 472-0043
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5246
SC
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6794PA
—
SC
Enumeration date
02/06/2024
Last updated
03/20/2026
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