Breona A Mack, PA
Physician Assistant in Columbia, South Carolina
1366363152- Practice location
- 14 Richland Medical Park Dr Ste 20, Columbia, SC 29203-6877
- Phone
- 803-296-7846
- Fax
- 803-296-9699
- Last updated
- November 13, 2026
Breona Alexis Mack is a Physician Assistant based in Columbia, SC. Breona Alexis Mack practices in Columbia, SC and has the professional credentials of PA. The NPI Number for Breona Alexis Mack is 1366363152 and holds a License No. 6540. The current practice location address for Breona Alexis Mack is 14 Richland Medical Park Dr Ste 20, Columbia, SC 29203-6877 and can be reached out via phone at 803-296-7846 and via fax at 803-296-9699.
Provider Profile Details
- NPI Number
- 1366363152
- Provider Name
- Breona Alexis Mack
- Credential
- PA
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 14 Richland Medical Park Dr Ste 20, Columbia, SC 29203-6877
- Phone Number
- 803-296-7846
- Fax Number
- 803-296-9699
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- July 24, 2026
- Last Update Date
- November 13, 2026
- Certification Date
- November 13, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 14 Richland Medical Park Dr Ste 20
Columbia, SC 29203-6877 - City
- Columbia
- State
- South Carolina
- Zip
- 29203-6877
- Phone Number
- 803-296-7846
- Fax Number
- 803-296-9699
Provider Business Mailing Address Details
- Address
- 300 E Mcbee Ave Fl 4
Greenville, SC 29601-2842 - City
- Greenville
- State
- SC
- Zip
- 29601-2842
License Information
- License Number
- 6540
- Taxonomy
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Breona A Mack, PA?
The NPI number of Breona A Mack, PA is 1366363152. It was assigned on July 24, 2026 and is currently active in the NPPES registry.
What is the specialty of Breona A Mack, PA?
Breona A Mack, PA is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed under license number 6540.
Where does Breona A Mack, PA practice?
The practice location is 14 Richland Medical Park Dr Ste 20, Columbia, SC 29203-6877. The office can be reached at 803-296-7846 (phone) or 803-296-9699 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1366363152 directly on the NPPES registry website.