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NPI Code Detail

MEDICARE: ELIZABETH SPITZ PA-C

MEDICARE: ELIZABETH SPITZ 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
12255A2300XAthletic Trainer060502081SC
2363AS0400XSurgical Physician Assistant

General Provider Information

NPI Number : 1588762546
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH SPITZ PA-C
Provider Business Mailing Address
First Line : 1327 ASHLEY RIVER RD
Second Line : BUILDING B
City : CHARLESTON
State : SC
Zip : 29407-5384
Country : US
Telephone Number : 843-577-4551
Fax Number :
Provider Business Practice Location Address
First Line : 1327 ASHLEY RIVER RD
Second Line : BUILDING B
City : CHARLESTON
State : SC
Zip : 29407-5384
Country : US
Telephone Number : 843-577-4551
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 09/12/2011

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Directions to “ ELIZABETH SPITZ PA-C” Practice Location

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