NPI 1003677220

Jeffshan Sam Jose John Ponnarasu, PA

Practitioner Physician Assistant Cheraw, SC

Practice location

Address: 316 2nd St, Cheraw, SC 29520-2404
Phone: (843) 921-4851
Mailing address: 709 Mall Blvd, Savannah, GA 31406-4805

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 5338 (SC)

Other Physician Assistant providers in South Carolina →

Registry record

NPI: 1003677220
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Jan 2024
Record last updated: 11 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.