Provider Demographics
NPI:1902305709
Name:PRIVETTE, CHRISTOPHER BRITTON (PA)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRITTON
Last Name:PRIVETTE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:BISHOPVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29010-1013
Mailing Address - Country:US
Mailing Address - Phone:803-229-2653
Mailing Address - Fax:
Practice Address - Street 1:2475 BROAD ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-1820
Practice Address - Country:US
Practice Address - Phone:803-778-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2928363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant