Individual
SKYLER ALEXIS FOUNTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
830 ROBERTSON BLVD, WALTERBORO, SC 29488-3081
(843) 781-7428
(843) 781-7429
Mailing address
8906 TWO NOTCH RD, COLUMBIA, SC 29223-6366
(803) 254-3676
(803) 254-3678
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7106PA
—
SC
Enumeration date
04/22/2024
Last updated
04/23/2025
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