Provider Demographics
NPI:1578588240
Name:GUNN, ROBIN PAULEY (PA-C)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:PAULEY
Last Name:GUNN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:R
Other - Last Name:PAULEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
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 STE 400
Practice Address - Street 2:
Practice Address - City:MT 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:2006-07-13
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPA2496363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP6337OtherGROUP MEDICAID
SC2577PAMedicaid
SC1527331OtherCIGNA PROVIDER ID
SC4949292OtherAETNA PIN NO.