Canavan, Amy Langham
Canavan, Amy Langham is an individual health care provider with primary practice located at 124 Professional Park Dr Suite A, Conway SC 29526-9260. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Canavan, Amy Langham can be contacted via phone (843) 234-8788.Contact Information
Primary practice address
124 Professional Park Dr Suite A
Conway SC 29526-9260
Phone: (843) 234-8788
Fax: (843) 234-8787
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 86335 | South Carolina |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 86335 | South Carolina |
Profile Details
| NPI number | 1376574038 |
|---|---|
| LBN Legal business name | Canavan, Amy Langham |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2006 |
| Last updated | Oct 18th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376574038 | NPPES |
| South Carolina | MEDICAID | 863355 |
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