Provider Demographics
NPI:1710285051
Name:CAHOY, HEATHER SUZANNAH (PA)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:SUZANNAH
Last Name:CAHOY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MRS
Other - First Name:HEATHER
Other - Middle Name:SUZANNAH
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:920 DOUG WHITE DR STE 510
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4183
Mailing Address - Country:US
Mailing Address - Phone:843-497-7772
Mailing Address - Fax:843-848-7530
Practice Address - Street 1:920 DOUG WHITE DR STE 510
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4183
Practice Address - Country:US
Practice Address - Phone:843-497-7772
Practice Address - Fax:843-848-7530
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9105873363A00000X
SD0821363A00000X
SC2152363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2010PAMedicaid
SC2010PAMedicaid