Provider Demographics
NPI:1457159584
Name:RYAN, SARAH EXUM (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:EXUM
Last Name:RYAN
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 SOUTHGATE CT
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-4408
Mailing Address - Country:US
Mailing Address - Phone:843-457-2003
Mailing Address - Fax:
Practice Address - Street 1:8220 NIGELS DR
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4125
Practice Address - Country:US
Practice Address - Phone:843-692-0968
Practice Address - Fax:843-692-2688
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5768363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant