| NPI | 1013280650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CANNON PHELPS Psychiatrist 843-400-4089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC SC1442.MDO) |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2012-02-13 |