Provider Demographics
NPI:1720275266
Name:ZEIDMAN, CHERYL LORI (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:LORI
Last Name:ZEIDMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1775 TIMMONS ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7598
Mailing Address - Country:US
Mailing Address - Phone:954-214-8960
Mailing Address - Fax:843-449-9531
Practice Address - Street 1:5046 HIGHWAY 17 BYP S STE 200
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-4503
Practice Address - Country:US
Practice Address - Phone:843-449-0453
Practice Address - Fax:843-449-9531
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2024-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3887207N00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology