Provider Demographics
NPI:1942655303
Name:DEL REAL, JEFFREY JULIAN (PA-C)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:JULIAN
Last Name:DEL REAL
Suffix:
Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:PO BOX 749306
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9306
Mailing Address - Country:US
Mailing Address - Phone:864-967-7028
Mailing Address - Fax:
Practice Address - Street 1:35 RAY E TALLEY CT
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29680-6772
Practice Address - Country:US
Practice Address - Phone:864-967-7028
Practice Address - Fax:864-228-0915
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2024-11-03
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant