IndividualActive
Andrew Stag
NPI 1639868680 · Medical Physician Assistant · Beaufort, SC
Provider details
- NPI number
- 1639868680
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 5201 (SC)
Mailing address
1 Pinckney Blvd
Beaufort, SC 29902-6122
Registry dates
- Enumerated
- 2023-05-04
- Last updated
- 2024-11-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.