Individual provider · Type 1 NPI

Scott David Ethridge, PA-C

Medical Physician Assistant · Charleston, WV

NPI number 1326228552 Active

Practice location

3100 Maccorkle Ave SE, Suite 806
Charleston, WV 25304-1223

Call (304) 344-9480 Map

Fax (304) 344-9481

Mailing address

4619 Kanawha Ave SW, Suite 806
South Charleston, WV 25309-1319

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X01317 (WV)

Medical Physician Assistant: Definition to come...

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About NPI 1326228552

Scott David Ethridge, PA-C's National Provider Identifier is 1326228552, issued on Nov 5, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Charleston, WV. The record was last updated on Jan 24, 2017.