Individual
SAMANTHA ANNE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8550
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1714
SC
363A00000X
Physician Assistant
2722
TN
363A00000X
Physician Assistant
PA9106798
FL
363AM0700X
Medical Physician Assistant
1714
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006628900
—
FL
Enumeration date
12/02/2011
Last updated
11/24/2020
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