Individual
KATHERYN DIXON ISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 HALTON VILLAGE CIR, GREENVILLE, SC 29607-6825
(864) 455-1600
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8617
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
33613
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
336130
—
SC
Enumeration date
06/07/2011
Last updated
05/23/2021
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