Provider Demographics
NPI:1376822627
Name:WINTER, MICHAEL A (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:A
Last Name:WINTER
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:929 BOWMAN RD
Mailing Address - Street 2:STE 400
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3237
Mailing Address - Country:US
Mailing Address - Phone:843-730-4124
Mailing Address - Fax:843-806-4295
Practice Address - Street 1:929 BOWMAN RD
Practice Address - Street 2:STE 400
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3237
Practice Address - Country:US
Practice Address - Phone:843-730-4124
Practice Address - Fax:843-806-4295
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2019-06-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LAPA.200517363A00000X
SCPA3222363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant