Fabyanic, Matthew Kenneth
Fabyanic, Matthew Kenneth is an individual health care provider with primary practice located at 2093 Henry Tecklenburg Dr Ste 200E , Charleston SC 29414-5742. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Fabyanic, Matthew Kenneth can be contacted via phone (843) 958-2500.Contact Information
Primary practice address
2093 Henry Tecklenburg Dr Ste 200E
Charleston SC 29414-5742
Phone: (843) 958-2500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 2242 | South Carolina |
Profile Details
| NPI number | 1629049697 |
|---|---|
| LBN Legal business name | Fabyanic, Matthew Kenneth |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 30th, 2006 |
| Last updated | Jan 31st, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629049697 | NPPES |
| South Carolina | MEDICAID | 2082PA |
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