Provider Demographics
NPI:1346350329
Name:PAPAHARIS, MERCEDES D (APRN)
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:D
Last Name:PAPAHARIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 SARAZEN DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-8742
Mailing Address - Country:US
Mailing Address - Phone:203-644-2543
Mailing Address - Fax:
Practice Address - Street 1:181 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29424-5728
Practice Address - Country:US
Practice Address - Phone:843-953-5520
Practice Address - Fax:203-966-8223
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18363363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004238607Medicaid
CT004238607Medicaid