Provider Demographics
NPI:1952375347
Name:MCNEILL, APRIL M (PHYSICIAN'S ASSISTAN)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:M
Last Name:MCNEILL
Suffix:
Gender:F
Credentials:PHYSICIAN'S ASSISTAN
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:S
Other - Last Name:MIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3600 FOREST DR STE 400
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-4057
Mailing Address - Country:US
Mailing Address - Phone:803-779-7316
Mailing Address - Fax:803-343-2538
Practice Address - Street 1:3600 FOREST DR STE 400
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-4057
Practice Address - Country:US
Practice Address - Phone:803-779-7316
Practice Address - Fax:803-343-2538
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1083363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0368PAMedicaid
SCMM1350963OtherDEA
SCQ578507479Medicare ID - Type Unspecified
SCMM1350963OtherDEA