| Meredith Gray Provost, PA-C | |
|
129 N Washington St, Sumter, SC 29150-4949 | |
| (803) 774-9000 | |
| Not Available |
| Full Name | Meredith Gray Provost |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Medical |
| Location | 129 N Washington St, Sumter, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699026930 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 1827 (South Carolina) | Primary |
| Entity Name | Acs Primary Care Physicians - Southeast PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861430555 PECOS PAC ID: 5193620714 Enrollment ID: O20090401000270 |
| Mailing Address | Practice Location Address |
|---|---|
| Meredith Gray Provost, PA-C 129 N Washington St, Sumter, SC 29150-4949 Ph: (843) 270-3440 | Meredith Gray Provost, PA-C 129 N Washington St, Sumter, SC 29150-4949 Ph: (803) 774-9000 |
Mrs. Kimberly W Reisenauer, P.A. Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 325 Broad St, Suite 100, Sumter, SC 29150 Phone: 803-773-5227 Fax: 803-774-5400 |
Mrs. Temisha H Budden, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 12 Barnette Dr, Sumter, SC 29150 Phone: 803-773-5442 Fax: 803-778-2394 |
Mrs. Lauren Marie Pepin, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 635 W Wesmark Blvd, Sumter, SC 29150 Phone: 803-469-7500 Fax: 803-469-7521 |
Mrs. Julie Ann West, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 325 W Liberty St, Sumter, SC 29150 Phone: 803-774-7000 Fax: 803-774-7004 |
Alexandra Lyn Condy, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 129 N Washington St, Sumter, SC 29150 Phone: 803-774-9099 |
Steven Jon Bosc Ii, PA-C Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 325 Broad St, Sumter, SC 29150 Phone: 803-773-5227 |
Mrs. April T Rogers, PAC Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 641 W Wesmark Blvd, Sumter, SC 29150 Phone: 803-905-6944 Fax: 803-469-3944 |