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NPI Code Detail

MEDICARE: MRS. LAURA B KAISER PA-C

MEDICARE: MRS. LAURA B KAISER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant2290SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA2290OTHERSCSTATE LICENSE BOARD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033503537
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA B KAISER PA-C
Provider Business Mailing Address
First Line : 955 RIBAUT RD
Second Line : BMAC CREDENTIALING
City : BEAUFORT
State : SC
Zip : 29902-5441
Country : US
Telephone Number : 843-522-5674
Fax Number : 843-522-5678
Provider Business Practice Location Address
First Line : BEAUFORT MEMORIAL SURGICAL SPECIALISTS
Second Line : 1680 RIBAUT RD
City : PORT ROYAL
State : SC
Zip : 29935-2008
Country : US
Telephone Number : 843-524-8171
Fax Number : 844-296-2307
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2015
Last Update Date : 03/28/2019

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Directions to “ MRS. LAURA B KAISER PA-C” Practice Location

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