Provider Demographics
NPI:1568898302
Name:HARWYN, ASHLEY MEYERS (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:MEYERS
Last Name:HARWYN
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:8536 PALMETTO COMMERCE PKWY
Mailing Address - Street 2:STE 401
Mailing Address - City:LADSON
Mailing Address - State:SC
Mailing Address - Zip Code:29456-6700
Mailing Address - Country:US
Mailing Address - Phone:843-767-2121
Mailing Address - Fax:843-767-2102
Practice Address - Street 1:5319 PARKSHIRE WAY
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418-2051
Practice Address - Country:US
Practice Address - Phone:843-767-2121
Practice Address - Fax:843-767-2102
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC1980363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1739PAMedicaid
SCP01300694OtherRR MEDICARE
SCSC20906834Medicare PIN