Individual
MADISON KOELBL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9330 MEDICAL PLAZA DR, NORTH CHARLESTON, SC 29406-9104
(843) 797-7000
Mailing address
9330 MEDICAL PLAZA DR, NORTH CHARLESTON, SC 29406-9104
(843) 797-7000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/08/2024
Last updated
01/27/2025
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