Healthcare Provider Details

I. General information

NPI: 1609675024
Provider Name (Legal Business Name): MISS HANNAH NEIMY
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 ASHLEY AVE
CHARLESTON SC
29425-0100
US

IV. Provider business mailing address

171 ASHLEY AVE
CHARLESTON SC
29425-0100
US

V. Phone/Fax

Practice location:
  • Phone: 843-996-8900
  • Fax:
Mailing address:
  • Phone: 843-270-6166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberLL97445
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: