Provider Demographics
NPI:1710644612
Name:MAGEE, PATRICK BRYAN (PA-C)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:BRYAN
Last Name:MAGEE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 DICEY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-2510
Mailing Address - Country:US
Mailing Address - Phone:803-856-1304
Mailing Address - Fax:
Practice Address - Street 1:674 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4882
Practice Address - Country:US
Practice Address - Phone:803-773-5227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-26
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4215363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant