Individual
MS. HEATHER MARIE BALDASSARRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2361 CYPRESS CIR, CONWAY, SC 29526-8921
(843) 347-7291
(843) 347-0139
Mailing address
300 SINGLETON RIDGE RD, ATTN CREDENTIALING, CONWAY, SC 29526-9142
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
4240
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5852PA
—
SC
Enumeration date
08/09/2016
Last updated
08/22/2025
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