Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Ethan Brody Clontz, PA-C

Individual provider Physician Assistant · NPI 1275131054

Mr. Ethan Brody Clontz, PA-C is a Physician Assistant in Charleston, South Carolina. Qualified in 2020, 6 years ago. Practices with McLeod Physician Associates II, a 542-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
6
Licensed in
SC
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

171 Ashley Ave
Charleston, SC 29425-6483
Phone: (843) 792-1414
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3 Richland Medical Park Dr Ste 310, Columbia, SC 29203-6862 — (803) 434-8323

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 3574 (SC)

Record details

NPI number1275131054
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 13, 2020
Last updated in NPPESMay 24, 2022
Certification dateMay 24, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice McLeod Physician Associates Ii — 542 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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