Provider Demographics
NPI:1679796254
Name:MCLAUCHLIN, SARAH K (PA-C, MPAS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:K
Last Name:MCLAUCHLIN
Suffix:
Gender:F
Credentials:PA-C, MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1893 SAINT MATTHEWS RD
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-2403
Mailing Address - Country:US
Mailing Address - Phone:803-395-4497
Mailing Address - Fax:803-536-0998
Practice Address - Street 1:725 HARRY C. RAYSOR DR.
Practice Address - Street 2:
Practice Address - City:ST. MATTHEWS
Practice Address - State:SC
Practice Address - Zip Code:29135
Practice Address - Country:US
Practice Address - Phone:803-874-3902
Practice Address - Fax:803-874-3905
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1075OTO363A00000X
SC1075363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP0753Medicaid
SCGP0753Medicaid
SCAA2793Medicare UPIN