Individual
MRS. MEGAN LYNNE WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8900
(843) 792-9393
Mailing address
96 JONATHAN LUCAS ST # ST613, CHARLESTON, SC 29425-8900
(843) 792-9393
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1704
SC
363AS0400X
Surgical Physician Assistant
TL 1704
SC
Other
Enumeration date
10/13/2011
Last updated
10/20/2020
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