Healthcare Provider Details

I. General information

NPI: 1053956474
Provider Name (Legal Business Name): SARAH BARRETT EKMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2019
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 SUMMERPLACE DR
WEST COLUMBIA SC
29169-3058
US

IV. Provider business mailing address

131 SUMMERPLACE DR
WEST COLUMBIA SC
29169-3058
US

V. Phone/Fax

Practice location:
  • Phone: 803-794-4585
  • Fax: 803-796-8924
Mailing address:
  • Phone: 803-794-4585
  • Fax: 803-796-8924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3420
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: