| Amy Langham Canavan, MD | |
|
124 Professional Park Dr, Suite A, Conway, SC 29526-9260 | |
| (843) 234-8788 | |
| (843) 234-8787 |
| Full Name | Amy Langham Canavan |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 124 Professional Park Dr, Conway, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376574038 | NPI | - | NPPES |
| 863355 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208M00000X | Hospitalist | 86335 (South Carolina) | Secondary |
| 208000000X | Pediatrics | 86335 (South Carolina) | Primary |
| Entity Name | Inova Health Care Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952320061 PECOS PAC ID: 2466351093 Enrollment ID: O20040102000644 |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Langham Canavan, MD 300 Singleton Ridge Rd, Attention Patient Accounting, Conway, SC 29526-9142 Ph: (843) 234-6946 | Amy Langham Canavan, MD 124 Professional Park Dr, Suite A, Conway, SC 29526-9260 Ph: (843) 234-8788 |
Danika Lauren Alexander Borden, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Singleton Ridge Rd Ofc, Conway, SC 29526 Phone: 843-347-7111 | |
Heather R Grabowski, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 243 Singleton Ridge Rd, Conway, SC 29526 Phone: 843-248-4700 | |
Ashwin Attiguppam Mallikarjun, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1608 Main St, Conway, SC 29526 Phone: 843-248-4700 Fax: 843-248-3145 | |
Mrs. Isabella Andrea Vallenilla Gallardo, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Singleton Ridge Rd, Conway, SC 29526 Phone: 843-347-7111 | |
Dr. Stephen Alexander Corontzes, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 600 Singleton Ridge Rd, Conway, SC 29526 Phone: 843-347-9099 Fax: 843-347-9029 | |
Dr. Lina Abdelmajid Hajar, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 243 Singleton Ridge Rd, Conway, SC 29526 Phone: 843-248-4700 | |
Eugenia Gainzeo Cooper-merchant, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 100 Professional Park Dr, Conway, SC 29526 Phone: 843-234-0005 |