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NPI Code Detail

MEDICARE: BRITTANY MCCALL DIEFFENBACH PA

MEDICARE: BRITTANY MCCALL DIEFFENBACH 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
1363A00000XPhysician Assistant3399SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13399OTHERSCSC LICENSE

General Provider Information

NPI Number : 1699311019
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANY MCCALL DIEFFENBACH PA
Provider Business Mailing Address
First Line : PO BOX 421718
Second Line :
City : GEORGETOWN
State : SC
Zip : 29442-4203
Country : US
Telephone Number : 843-527-7000
Fax Number :
Provider Business Practice Location Address
First Line : 2185 N FRASER ST
Second Line :
City : GEORGETOWN
State : SC
Zip : 29440-6418
Country : US
Telephone Number : 842-527-1800
Fax Number : 843-527-6528
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2019
Last Update Date : 10/03/2025

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Directions to “ BRITTANY MCCALL DIEFFENBACH PA” Practice Location

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