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NPI Code Detail

MEDICARE: LAURA L ERNST PA

MEDICARE: LAURA L ERNST PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantMLA1250SC
2363AS0400XSurgical Physician Assistant4461SC

General Provider Information

NPI Number : 1407043789
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA L ERNST PA
Provider Business Mailing Address
First Line : PO BOX 6069
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29171-6069
Country : US
Telephone Number : 803-791-2000
Fax Number :
Provider Business Practice Location Address
First Line : 222 E MEDICAL LN STE 101
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29169-4850
Country : US
Telephone Number : 803-739-3660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2007
Last Update Date : 01/16/2024

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Directions to “ LAURA L ERNST PA” Practice Location

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