Provider Demographics
NPI:1649392440
Name:TROGDON, PASCHA E
Entity Type:Individual
Prefix:MS
First Name:PASCHA
Middle Name:E
Last Name:TROGDON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 S MCQUEEN ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5118
Mailing Address - Country:US
Mailing Address - Phone:843-230-6138
Mailing Address - Fax:843-395-2595
Practice Address - Street 1:203 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:SC
Practice Address - Zip Code:29532-3953
Practice Address - Country:US
Practice Address - Phone:843-395-6020
Practice Address - Fax:843-395-2595
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCBM5921386246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC14599OtherTECHNICIAN