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Individual

EMILY A BAGWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
8091 RIVERS AVE, NORTH CHARLESTON, SC 29406-9236
(843) 572-7000
(843) 572-4070
Mailing address
4416 FOREST DR, 2ND FLOOR, COLUMBIA, SC 29206-3104
(803) 782-4278
(803) 782-3445

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1148
SC

Other

Enumeration date
11/14/2006
Last updated
07/08/2007
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