Healthcare Provider Details

I. General information

NPI: 1104358324
Provider Name (Legal Business Name): ELIZABETH BROWN HEYWARD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 MIDLAND PKWY
SUMMERVILLE SC
29485-8104
US

IV. Provider business mailing address

295 MIDLAND PKWY
SUMMERVILLE SC
29485-8104
US

V. Phone/Fax

Practice location:
  • Phone: 843-970-5000
  • Fax:
Mailing address:
  • Phone: 843-970-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number93321
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: