MEDICARE: EMILY SUMNER BONN PA-C

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
1	363A00000X	Physician Assistant	4686	SC

General Provider Information

NPI Number	:	1568313492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY SUMNER BONN PA-C

Provider Business Mailing Address
First Line	:	562 KING ST STE 100
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29403-5520
Country	:	US
Telephone Number	:	843-737-0568
Fax Number	:

Provider Business Practice Location Address
First Line	:	562 KING ST STE 100
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29403-5520
Country	:	US
Telephone Number	:	843-737-0568
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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Directions to “ EMILY SUMNER BONN PA-C” Practice Location

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