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Individual

SAMUEL HOLBROOK HALVERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
204 W HILL BLVD, CHARLESTON AFB, SC 29404-4704
(951) 313-7307
Mailing address
204 W HILL BLVD, CHARLESTON AFB, SC 29404-4704
(951) 313-7307

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2925
SC

Other

Enumeration date
11/01/2006
Last updated
04/27/2018
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