Provider Demographics
NPI:1962123612
Name:HOWARD, EMILY DIANNA (OD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:DIANNA
Last Name:HOWARD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 KING CHARLES RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-2239
Mailing Address - Country:US
Mailing Address - Phone:803-521-7987
Mailing Address - Fax:
Practice Address - Street 1:11030 GOLF LINKS DR STE 204
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-8047
Practice Address - Country:US
Practice Address - Phone:704-943-5110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2363152W00000X
NC2699152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist