Healthcare Provider Details

I. General information

NPI: 1013738145
Provider Name (Legal Business Name): MARGARET LYNNE MILLER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 SPRINGVIEW LN
SUMMERVILLE SC
29485-8154
US

IV. Provider business mailing address

160 RIVERLAND DR
CHARLESTON SC
29412-2081
US

V. Phone/Fax

Practice location:
  • Phone: 843-832-5096
  • Fax:
Mailing address:
  • Phone: 224-688-9520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5597
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: