Individual provider · Type 1 NPI

London Judith Miccichi, PA-C

Physician Assistant · Mount Pleasant, SC

NPI number 1861115313 Active

Practice location

180 Wingo Way Ste 207
Mount Pleasant, SC 29464-1811

Call (843) 884-5101 Map

Fax (843) 606-7997

Mailing address

PO Box 751649
Charlotte, NC 28275-1649

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X4588 (SC)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1861115313

London Judith Miccichi, PA-C's National Provider Identifier is 1861115313, issued on Sep 20, 2022. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Mount Pleasant, SC. The record was last updated on Sep 25, 2025.