Individual
LISA BARR SURRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
180 WINGO WAY, SUITE 306, MT PLEASANT, SC 29464-1810
(843) 884-0447
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1167
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9223
MEDICARE GROUP #-ROPER SAINT FRANCIS HEALTHCARE
SC
Enumeration date
08/06/2007
Last updated
06/18/2009
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