Individual
MRS. MOLLY GRAVES MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2097 HENRY TECKLENBURG DR STE 312W, CHARLESTON, SC 29414
(843) 789-1800
(843) 606-8036
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2337
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2456PA
—
SC
Enumeration date
07/30/2012
Last updated
03/23/2021
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