NPI 1124740865

Gabriella Leary, PAC

Practitioner Medical Physician Assistant Surfside Beach, SC

Practice location

Address: 1413 Highway 17 N, Surfside Beach, SC 29575-6012
Phone: (843) 238-5654
Fax: (843) 238-1624
Mailing address: 300 Singleton Ridge Rd Attention Pns Credentialing, Conway, SC 29526-9142

Registered specialties

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence 4618PA (SC)

Other Physician Assistant providers in South Carolina →

Registry record

NPI: 1124740865
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Sep 2022
Record last updated: 20 Mar 2023

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.