BRIAN R OBENZA (NPI# 1053613786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053613786 |
Entity Type | Individual |
Full Name | BRIAN R OBENZA |
Credential | PA-C |
Practice Address |
180 Wingo Way Suite 204 Mt Pleasant SC 29464-1810 |
Practice Telephone | 8435341770 |
Practice Fax Number | 8435341767 |
Mailing Telephone | 8435341770 |
Mailing Fax Number | 8435341767 |
Enumeration Date | 2010-12-01 |
Last Update Date | 2010-12-01 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
TL1599 | SC | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
180 WINGO WAY SUITE 204 |
City | MT PLEASANT |
State | SC |
Zip Code | 29464-1810 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003815259 | Stanley C Hall | Urology | 180 Wingo Way, Suite 304, Mt Pleasant, SC 29464-1810 | 2005-07-19 |
1114371846 | Roper Saint Francis Physicians Network | Durable Medical Equipment & Medical Supplies | 180 Wingo Way, Suite 308, Mt Pleasant, SC 29464-1810 | 2016-04-19 |
1285098939 | Lillian Brandt | Specialist | 180 Wingo Way, Suite 301, Mt Pleasant, SC 29464-1810 | 2016-04-08 |
1235598525 | Roper Saint Francis Physicians Network | Internal Medicine | 180 Wingo Way, Suite 110, Mt Pleasant, SC 29464-1810 | 2016-02-16 |
1598142101 | Roper Saint Francis Physicians Network | Obstetrics & Gynecology | 180 Wingo Way, Suite 308, Mt Pleasant, SC 29464-1810 | 2015-05-04 |
1497184667 | Charleston Ent Associates LLC | Pharmacy | 180 Wingo Way, Suite 103, Mt Pleasant, SC 29464-1810 | 2013-11-07 |
1629327713 | Jessica Michelle Chepa | Nurse Practitioner | 180 Wingo Way, Suite 304, Mt Pleasant, SC 29464-1810 | 2012-09-05 |
1093091761 | Jesse William Price IIi | Physician Assistant | 180 Wingo Way, Suite 306, Mt Pleasant, SC 29464-1812 | 2011-10-26 |
1659663441 | Andrew Clarke Flandry | Family Medicine | 180 Wingo Way, Suite 207, Mt Pleasant, SC 29464-1810 | 2011-05-11 |
1104128529 | Roper Saint Francis Physicians Network | Surgery | 180 Wingo Way, Suite 308, Mt Pleasant, SC 29464-1810 | 2010-11-18 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811548241 | Bradley Paul Anuszkiewicz | Chiropractor | 1501 Johnnie Dodds Blvd, Suite C, Mount Pleasant, SC 29464 | 2019-09-26 |
1447808696 | Laura Mariah Crouse | Speech-Language Pathologist | Coastal Therapy Services, 1127 Queensborough Blvd, Mt Pleasant, SC 29464 | 2019-08-30 |
1912461807 | Independent Optical | Optometrist | 1710 Shoremead Rd, Suite 420, Mount Pleasant, SC 29464 | 2019-01-25 |
1417446204 | Michael Adam Sugarman | Clinical Neuropsychologist | 1459 Stuart Engals Blvd Ste 204a, Mt Pleasant, SC 29464 | 2018-05-07 |
1578064192 | Ancillary Specialists LLC | Durable Medical Equipment & Medical Supplies | 636 Long Point Road, Unit G, #19, Mount Pleasant, SC 29464 | 2018-02-28 |
1346769015 | Christin Solomon Zerega | Counselor | Lowcountry Psychiatry Group, 913 Bowman Rd, #4, Mount Pleasant, SC 29464 | 2017-09-14 |
1336660315 | Charleston Neuropsychology LLC | Psychologist | 1459 Stuart Engals Blvd., Suite 204a, Mount Pleasant, SC 29464 | 2017-06-29 |
1790219970 | Adam Hudepohl | Family Medicine | 1400 Ben Sawyer Blvd, Mt Pleasant, SC 29464 | 2017-04-14 |
1386181204 | Alicia Taylor | Speech-Language Pathologist | 381 Stonewall Ct Apt 6207, Mount Pleasant, SC 29464 | 2017-01-30 |
1285181941 | Tara Lynn Mast | Physical Therapist | 1400 Caliper Oak Circle, Apt 316, Mount Pleasant, SC 29464 | 2016-09-09 |
Find all providers in zip 29464 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073022612 | Gina Marie Sanitato | Physician Assistant | 1300 Hospital Dr Ste 300, Mt Pleasant, SC 29464-3217 | 2017-09-27 |
1417201419 | Timothy Roger Stevens | Physician Assistant | 1075 S Hwy 89, Mt Pleasant, UT 84647 | 2012-10-30 |
1487926168 | Heather Marie Patterson | Physician Assistant | 828 West Main St, Mt Pleasant, PA 15666 | 2012-01-27 |
1023111275 | Michael T Fillenworth | Physician Assistant | 2591 South Leaton Rd, Mt Pleasant, MI 48858 | 2006-09-06 |
1811944168 | Marilyn P Mcginty | Physician Assistant | 1629 E High St, Mt Pleasant, MI 48858-8409 | 2006-05-30 |
1023075215 | Allan R Riggs | Physician Assistant | 600 East Preston, Cmu Health Services, Foust Hall 108, Mt Pleasant, MI 48859-0001 | 2006-05-01 |
1427028034 | Lara H Blosser | Physician Assistant | 508 S Church St, Mt Pleasant, PA 15666-1702 | 2006-01-25 |
1699753244 | Maureen L George | Physician Assistant | 828 W Main St, Mt Pleasant, PA 15666-1730 | 2006-01-04 |
1316594609 | Kaitlin Roper | Physician Assistant | 913 Bowman Rd, Mt Pleasant, SC 29464-3235 | 2019-08-21 |
1558831420 | Jacob P Crawford | Physician Assistant | 508 S Church St, Mt Pleasant, PA 15666-1702 | 2018-12-04 |
Find all providers in MT PLEASANT |
City | MT PLEASANT |
Zip Code | 29464 |
Please comment or provide details below to improve the information on BRIAN R OBENZA.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.