Individual
PATRICIA LYNN SANDGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2880 TRICOM ST, NORTH CHARLESTON, SC 29406-9171
(843) 797-5050
(843) 797-3633
Mailing address
2880 TRICOM ST, NORTH CHARLESTON, SC 29406-9171
(843) 797-5050
(843) 797-3633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
276
SC
363AS0400X
Surgical Physician Assistant
276
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03509A
—
SC
01
—
621330S
SELECT HLTH
SC
Enumeration date
07/13/2006
Last updated
07/16/2007
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