Individual
ASHLEY SIMONE MAYBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8004 MYRTLE TRACE DR STE 200, CONWAY, SC 29526-8945
(843) 347-8041
(843) 347-8042
Mailing address
300 SINGLETON RIDGE ROAD, ATTENTION PATIENT ACCOUNTING, CONWAY, SC 29526-9142
(843) 234-6946
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
84816
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D86830
LICENSE
MD
Enumeration date
04/14/2015
Last updated
09/30/2020
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