Individual
MIRIAM ISKANDAR OVERHOLSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1500 MAIN ST, CONWAY, SC 29526-3569
(843) 438-8470
Mailing address
1031 FIDDLEHEAD WAY, MYRTLE BEACH, SC 29579-3812
(843) 446-5221
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3762
SC
Other
Enumeration date
01/11/2021
Last updated
01/11/2021
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