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NPI Code Detail

MEDICARE: INA RAE TROUTMAN PA-C

MEDICARE:   INA RAE TROUTMAN  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 Assistant3111SC
2207N00000XDermatology Physician3111SC

General Provider Information

NPI Number : 1427526086
Entity Type Code : Individual
Provider Name (Legal Business Name) : INA RAE TROUTMAN PA-C
Provider Business Mailing Address
First Line : 7410 HIGHWAY 707
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29588-7304
Country : US
Telephone Number : 843-215-1100
Fax Number : 843-215-1211
Provider Business Practice Location Address
First Line : 7410 HIGHWAY 707
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29588-7304
Country : US
Telephone Number : 843-215-1100
Fax Number : 843-215-1211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2018
Last Update Date : 03/24/2025

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Directions to “ INA RAE TROUTMAN PA-C” Practice Location

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