Individual
MATTHEW THOMAS BEAUREGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2001 LAUREL ST, COLUMBIA, SC 29204-1018
(843) 254-3278
Mailing address
PO BOX 935722, ATLANTA, GA 31193-5722
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3986
SC
Other
Enumeration date
07/06/2021
Last updated
01/04/2022
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