Healthcare Provider Details

I. General information

NPI: 1700812153
Provider Name (Legal Business Name): HOLLY MAY WHEELING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 KNOX ABBOTT DR
CAYCE SC
29033-3323
US

IV. Provider business mailing address

PO BOX 6069
WEST COLUMBIA SC
29171-6069
US

V. Phone/Fax

Practice location:
  • Phone: 803-314-0660
  • Fax:
Mailing address:
  • Phone: 803-791-2203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number60182
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number94053
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: