Individual
JANET E HARRIS-HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1021 CIPRIANA DR STE 250, MYRTLE BEACH, SC 29572-4621
(910) 330-9080
Mailing address
1021 CIPRIANA DR STE 250, MYRTLE BEACH, SC 29572-4621
(843) 895-2120
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
200400873
NC
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
23058
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1377E
BCBS ID NUMBER
NC
01
—
23058
SC MED LIC
SC
05
—
891377E
—
NC
05
—
N0087E
—
SC
Enumeration date
10/06/2006
Last updated
02/02/2023
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