Staversky, Michael R.

Staversky, Michael R. is an individual health care provider with primary practice located at 3495 Iron Horse Rd , Ladson SC 29456-4319. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Staversky, Michael R. can be contacted via phone (843) 793-5970.

Contact Information

Primary practice address
3495 Iron Horse Rd Ladson SC 29456-4319
Phone: (843) 793-5970
Fax: (843) 419-5391
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 3892 South Carolina

Profile Details

NPI number 1093317646
LBN Legal business name Staversky, Michael R.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2020
Last updated Apr 26th, 2024 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093317646 NPPES
South Carolina MEDICAID 4578PA

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