Most Relevant Information
Provider Data
| NPI Number: | 1003677220 |
| Provider Name: | JEFFSHAN SAM JOSE JOHN PONNARASU PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 5338 |
Most Important Dates
| Enumeration Date: | 01/16/2024 |
| Last Updated: | 07/11/2024 |
Provider Practice Location
316 2ND ST
CHERAW
SC
295202404
Practice Location Phone/Fax
| Phone: | 8439214851 |
| Fax: |
Provider Mailing Location
709 MALL BLVD
SAVANNAH
GA
314064805
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |