MEDICARE: DR. SUSAN A. HOLT O.D.

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	152W00000X	Optometrist	1258	SC

General Provider Information

NPI Number	:	1770557522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN A. HOLT O.D.

Provider Business Mailing Address
First Line	:	106 HARBOR OAKS DR
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-9364
Country	:	US
Telephone Number	:	843-325-7131
Fax Number	:

Provider Business Practice Location Address
First Line	:	1516 HIGHWAY 17 N UNIT 5
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-2276
Country	:	US
Telephone Number	:	843-663-2682
Fax Number	:

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

Provider Enumeration Date	:	02/16/2006
Last Update Date	:	01/30/2025

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