Provider Demographics
NPI:1548719578
Name:SCARBOROUGH, ELIZABETH (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:SCARBOROUGH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 BROCKMAN MCCLIMON RD
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-6608
Mailing Address - Country:US
Mailing Address - Phone:864-989-1432
Mailing Address - Fax:864-989-1462
Practice Address - Street 1:415 BROCKMAN MCCLIMON RD
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-6608
Practice Address - Country:US
Practice Address - Phone:864-989-1432
Practice Address - Fax:864-989-1462
Is Sole Proprietor?:No
Enumeration Date:2016-10-03
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2621363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant