MEDICARE: ALEXI MADISON BOBBA PA

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
1	363A00000X	Physician Assistant	4962	SC
2	363A00000X	Physician Assistant	022212	NY

General Provider Information

NPI Number	:	1467938274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXI MADISON BOBBA PA

Provider Business Mailing Address
First Line	:	808 AMELIA DR
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-5282
Country	:	US
Telephone Number	:	610-696-6227
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 ASHLEY AVE
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-7407
Country	:	US
Telephone Number	:	843-792-1414
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2018
Last Update Date	:	12/16/2024

Similar Medicare Providers

1083967889 — MRS. MICHELLE MARIE DEHMLOW CRNA
Practice Location Address:

171 ASHLEY AVE
CHARLESTON, SC
29425-7407

Practice Phone: 843-792-1414
Practice Fax: 910-772-9452

1720358229 — MR. MARCEL MARC ROYAL EMT - INTERMEDIATE
Practice Location Address:

8465 PATRIOT BLVD , APT. 1
NORTH CHARLESTON, SC
29420-7407

Practice Phone: 843-408-6408
Practice Fax:

1841974177 — DR. LUKE WESSLER MD
Practice Location Address:

169 ASHLEY AVE RM 202
CHARLESTON, SC
29425-1164

Practice Phone: 843-792-1414
Practice Fax:

1740608165 — DR. OLEKSANDRA LUPAK MD
Practice Location Address:

MUSC 171 ASHLEY AVE
CHARLESTON, SC
29425-2608

Practice Phone: 843-792-2300
Practice Fax:

1346282092 — RICHARD T TENCZAR MD
Practice Location Address:

171 ASHLEY AVE
CHARLESTON, SC
29425-0100

Practice Phone: 843-792-1414
Practice Fax:

1750789541 — LAUREN MARIE MIANULLI FNP
Practice Location Address:

171 ASHLEY AVE
CHARLESTON, SC
29425-0100

Practice Phone: 843-876-5026
Practice Fax:

Directions to “ ALEXI MADISON BOBBA PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.