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General NPI Number Information
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NPI Number | 1477540045
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Entity Type | Individual
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Provider Name | DARRYL K VALENTINE PA
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Gender | Male
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 12/19/2019
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Provider Practice Location Address
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Address Line | 235 SINGLETON RIDGE RD STE 103
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City | CONWAY
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State | SC
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Zip | 29526-9136
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Country | US
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Telephone | 843-347-2121
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Fax | 843-347-5565
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Provider Business Mailing Address
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Address Line | 235 SINGLETON RIDGE RD STE 103
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City | CONWAY
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State | SC
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Zip | 29526-9136
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Country | US
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Telephone | 843-347-2121
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Fax | 843-347-5565
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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 | 2493
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License Number State | SC
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