Healthcare Provider Details

I. General information

NPI: 1447859400
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL TROTTER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2020
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 SAINT JULIAN PL
COLUMBIA SC
29204-2419
US

IV. Provider business mailing address

1404 STONE CANYON WAY
LEWISVILLE TX
75067-4271
US

V. Phone/Fax

Practice location:
  • Phone: 803-771-7506
  • Fax:
Mailing address:
  • Phone: 714-356-2757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3818
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0010-10835
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: