Provider Demographics
NPI:1427100254
Name:QUARTERMAN, STEPHEN ADRIAN (PA)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ADRIAN
Last Name:QUARTERMAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:639 STEPHENSON AVE
Mailing Address - Street 2:STE A
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5970
Mailing Address - Country:US
Mailing Address - Phone:864-224-7577
Mailing Address - Fax:864-225-5165
Practice Address - Street 1:2503 NORTH MAIN STREET
Practice Address - Street 2:ANDERSON SKIN & CANCER CLINIC PA
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-3278
Practice Address - Country:US
Practice Address - Phone:864-224-7577
Practice Address - Fax:864-225-5165
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC944363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA0369Medicare UPIN
SCAA03692329Medicare ID - Type Unspecified