Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Ethan Revels

Individual provider Physician Assistant · NPI 1578486155

Mr. Ethan Revels is a Physician Assistant in Charleston, South Carolina. Licensed in South Carolina. Registered with an NPI since 2026.

Licensed in
SC
In the registry since
2026
Specialties on file
2

Practice location Address checks out

15102 Sweet Pl
Charleston, SC 29492-2831
Phone: (704) 689-3747
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (SC)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1578486155
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 31, 2026
Last updated in NPPESJuly 31, 2026
Certification dateJuly 31, 2026

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