Jeffshan Sam Jose John Ponnarasu, PA

NPI #1003677220 in Cheraw, South Carolina

Provider Information

NPI Number: 1003677220
Entity Type: Individual
Name: Jeffshan Sam Jose John Ponnarasu, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jan 16, 2024
Last Updated: Jul 11, 2024

Practice Location

Address: 316 2ND ST
City: Cheraw
State: South Carolina
ZIP Code: 29520-2404
Phone: (843) 921-4851

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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