Provider Demographics
NPI:1952065468
Name:GILCHREASE, AMARIS BERAIAH
Entity Type:Individual
Prefix:
First Name:AMARIS
Middle Name:BERAIAH
Last Name:GILCHREASE
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 1:838 W MEETING ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-6233
Mailing Address - Country:US
Mailing Address - Phone:803-828-7630
Mailing Address - Fax:
Practice Address - Street 1:838 W MEETING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-6233
Practice Address - Country:US
Practice Address - Phone:803-828-7630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-30
Last Update Date:2021-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical