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General NPI Number Information
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NPI Number | 1366878969
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Entity Type | Individual
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Provider Name | AMANDA GLOVER PYLES PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/16/2013
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 105 E HUGH ST
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-2925
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Country | US
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Telephone | 803-279-6800
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Fax | 803-279-2876
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Provider Business Mailing Address
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Address Line | PO BOX 2510
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City | EVANS
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State | GA
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Zip | 30809-2510
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Country | US
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Telephone | 706-922-8251
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Fax | 706-922-6695
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 7002
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2452
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License Number State | SC
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