Provider Demographics
NPI:1063407278
Name:JOSIAH-HOWZE, DARA ANITA (MD)
Entity type:Individual
Prefix:
First Name:DARA
Middle Name:ANITA
Last Name:JOSIAH-HOWZE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 CLEBOURNE ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-1758
Mailing Address - Country:US
Mailing Address - Phone:803-802-1301
Mailing Address - Fax:803-802-1303
Practice Address - Street 1:111 CLEBOURNE ST
Practice Address - Street 2:SUITE 110
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715
Practice Address - Country:US
Practice Address - Phone:803-802-1301
Practice Address - Fax:803-802-1303
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC99012142084P0804X
IN01052673A2084P0804X
SC314892084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC314895Medicaid
SCAA37229242Medicare PIN
SC314895Medicaid