person
Ethan Smallwood, PA
Student in an Organized Health Care Education/Training Program in West Columbia, South Carolina
NPI 1831899459

Ethan Smallwood is a Student in an Organized Health Care Education/Training Program based in West Columbia, SC. Ethan Smallwood practices in West Columbia, SC and has the professional credentials of PA. The NPI Number for Ethan Smallwood is 1831899459 and holds a License No. 4903 (South Carolina).

The current practice location address for Ethan Smallwood is 222 E Medical Ln Ste 101, West Columbia, SC and can be reached out via phone at 803-739-3660.

Location: 222 E Medical Ln Ste 101, West Columbia, SC, 29169-4850
person
Provider Profile Details
NPI Number
1831899459
Provider Name
Ethan Smallwood
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
222 E Medical Ln Ste 101, West Columbia, SC, 29169-4850
Phone Number
803-739-3660
Fax Number
Provider Enumeration Date
03/03/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
222 E Medical Ln Ste 101
City
State
Zip
29169-4850
Phone Number
803-739-3660
Fax Number
person
Provider Business Mailing Address Details
Address
222 E Medical Ln Ste 101
City
State
Zip
29169-4850
Phone Number
803-739-3660
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
4903 (South Dakota)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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