| NPI | 1215043872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT FAILE Vice President 843-856-7923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 174400000X Specialist |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2020-03-27 |