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Individual

MRS. MELISSA LYNN HAWVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1200 E MAIN ST STE 12, SPARTANBURG, SC 29307-1738
(864) 560-9260
(864) 560-9265
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-6554
(864) 560-7779

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
TL2727
SC
363AM0700X
Medical Physician Assistant
Primary
2727
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2889PA
SC
01
SCA2185019
MEDICARE PIN
SC
01
SCA2186067
MEDICARE PTAN
SC
01
SCA2186121
MEDICARE PTAN
SC
01
SCA218J577
MEDICARE PIN
SC
Enumeration date
08/21/2015
Last updated
01/18/2021
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