Provider Demographics
NPI:1003266941
Name:SUNDBERG, ASHLEY CURTIS (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:CURTIS
Last Name:SUNDBERG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:NICOLE
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2114 HIGHWAY 41 STE 105
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-6204
Mailing Address - Country:US
Mailing Address - Phone:843-388-9000
Mailing Address - Fax:843-388-6937
Practice Address - Street 1:2114 HIGHWAY 41 STE 105
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-6204
Practice Address - Country:US
Practice Address - Phone:843-388-9000
Practice Address - Fax:843-388-6937
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
SC3441363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant