MEDICARE: JH WYMER, LLC

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	103G00000X	Clinical Neuropsychologist	986	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639139462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JH WYMER, LLC

Provider Business Mailing Address
First Line	:	501 BELLE HALL PKWY UNIT 202
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-8322
Country	:	US
Telephone Number	:	843-412-0927
Fax Number	:	843-225-2323

Provider Business Practice Location Address
First Line	:	501 BELLE HALL PKWY UNIT 202
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-8322
Country	:	US
Telephone Number	:	843-412-0927
Fax Number	:	843-225-2323

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOY H WYMER
Credential	:	PHD
Telephone Number	:	843-412-0927

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	11/28/2023

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