Individual
AVNEET NAGRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2001 LAUREL ST FL 3, COLUMBIA, SC 29204-1018
(803) 227-5320
Mailing address
PO BOX 935722, ATLANTA, GA 31193-5722
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
3516
SC
363A00000X
Physician Assistant
Primary
3516
SC
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/11/2020
Last updated
06/06/2022
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