Provider Demographics
NPI:1801992433
Name:MELGAR, TAMMY STRICKLAND (PA-C)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:STRICKLAND
Last Name:MELGAR
Suffix:
Gender:F
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:PO BOX 14690
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29587-4690
Mailing Address - Country:US
Mailing Address - Phone:843-650-4006
Mailing Address - Fax:843-650-4225
Practice Address - Street 1:1945 GLENNS BAY RD
Practice Address - Street 2:
Practice Address - City:SURFSIDE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29575-4833
Practice Address - Country:US
Practice Address - Phone:843-650-4006
Practice Address - Fax:843-650-4225
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2174363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1994PAMedicaid
SC1994PAMedicaid
NC103239OtherNC MEDICAL BOARD