Gomez, Victor A
Gomez, Victor A is an individual health care provider with primary practice located at 2728 Sunset Blvd Ste 400 , West Columbia SC 29169-4839. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Gomez, Victor A can be contacted via phone (803) 936-7095.Contact Information
Primary practice address
2728 Sunset Blvd Ste 400
West Columbia SC 29169-4839
Phone: (803) 936-7095
Fax: (803) 936-7908
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 607 | South Carolina |
Profile Details
| NPI number | 1083672737 |
|---|---|
| LBN Legal business name | Gomez, Victor A |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2006 |
| Last updated | Oct 29th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083672737 | NPPES |
| South Carolina | MEDICAID | 0012PA |
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