Provider Demographics
NPI:1861625683
Name:CHAMBERS, GREGORY ALAN (PA-C)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:ALAN
Last Name:CHAMBERS
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:SC HOUSE CALLS INC
Mailing Address - Street 2:111 DOCTORS CIRCLE
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:800-491-0909
Mailing Address - Fax:919-439-3048
Practice Address - Street 1:SC HOUSE CALLS INC
Practice Address - Street 2:111 DOCTORS CIRCLE
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:800-491-0909
Practice Address - Fax:843-706-3350
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2023-10-27
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Provider Licenses
StateLicense IDTaxonomies
PAMA053992363AM0700X
SC1811363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA166239Medicare PIN