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General NPI Number Information
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NPI Number | 1053716050
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Entity Type | Individual
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Provider Name | ANNSLEY MARIE TROXELL PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/03/2014
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Last Update Date | 07/24/2019
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Provider Practice Location Address
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Address Line | BEAUFORT MEMORIAL SURGICAL SPECIALISTS 1680 RIBAUT RD
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City | PORT ROYAL
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State | SC
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Zip | 29935-2008
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Country | US
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Telephone | 843-524-2307
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Fax | 844-296-2307
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Provider Business Mailing Address
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Address Line | 955 RIBAUT RD BMAC CREDENTIALING COORDINATOR
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City | PORT ROYAL
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State | SC
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Zip | 29902-5441
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Country | US
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Telephone | 843-524-8171
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Fax | 844-296-2307
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2215
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License Number State | SC
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