Healthcare Provider Details

I. General information

NPI: 1336997196
Provider Name (Legal Business Name): MARISA MARIE HOWZE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2024
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 CROSS PARK LN STE 1B
SUMMERVILLE SC
29486-9007
US

IV. Provider business mailing address

145 FALL CREEK BLVD
SUMMERVILLE SC
29483-9469
US

V. Phone/Fax

Practice location:
  • Phone: 843-900-6161
  • Fax:
Mailing address:
  • Phone: 610-393-6087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6345
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9119043
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: