Provider Demographics
NPI:1073600698
Name:MERCIER, DENISE MCALLISTER (PA-C)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:MCALLISTER
Last Name:MERCIER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:MCALLISTER
Other - Last Name:MERCIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:989 RIBAUT RD STE 340
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5426
Mailing Address - Country:US
Mailing Address - Phone:435-218-4848
Mailing Address - Fax:843-521-8485
Practice Address - Street 1:989 RIBAUT RD STE 340
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5426
Practice Address - Country:US
Practice Address - Phone:843-521-8484
Practice Address - Fax:843-521-8485
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC636363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP197375773Medicare PIN