Individual
KATHERINE MOREDOCK HAYDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1175 COOK RD STE 215, ORANGEBURG, SC 29118-8201
(803) 395-3837
(803) 536-5122
Mailing address
PO BOX 12810, BELFAST, ME 04915-4019
(843) 797-5050
(843) 797-3633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2190
SC
363AM0700X
Medical Physician Assistant
Primary
2190
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902246077
ARCIS HEALTHCARE GROUP NPI NO.
SC
01
—
D043
ARCIS HEALTHCARE MEDICARE GROUP PTAN
SC
01
—
DU4331
ARCIS HEALTHCARE RAILROAD MEDICARE GROUP PTAN
SC
01
—
GP6337
ARCIS HEALTHCARE MEDICAID GROUP NO.
SC
Enumeration date
09/29/2014
Last updated
03/27/2019
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