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Individual

PHILLIP ANDREWS REATH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
8 RICHLAND MEDICAL PARK DR, SUITE 100, COLUMBIA, SC 29203
(803) 434-3800
(803) 744-2759
Mailing address
15 EXCHANGE DR, LUGOFF, SC 29078-9198
(803) 424-2207
(803) 408-3282

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2389
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2929PA
SC
01
SC79579988
MEDICARE
SC
Enumeration date
09/02/2015
Last updated
03/14/2019
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