MEDICARE: SAMANTHA HELMENSTINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	6069	SC

General Provider Information

NPI Number	:	1447015805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA HELMENSTINE

Provider Business Mailing Address
First Line	:	3223 EDISON CIR UNIT 6205
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-6847
Country	:	US
Telephone Number	:	843-359-2548
Fax Number	:

Provider Business Practice Location Address
First Line	:	8212 DEVON CT
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572-4178
Country	:	US
Telephone Number	:	843-839-2460
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2024
Last Update Date	:	12/10/2025

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