Individual
MARY L HEWETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2233 NORTHWOODS BLVD, NORTH CHARLESTON, SC 29406-4007
(866) 448-1641
Mailing address
PO BOX 751137, CHARLOTTE, NC 28275-1137
(866) 448-1641
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
A254
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0024PA
—
SC
Enumeration date
07/11/2006
Last updated
07/08/2007
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