| NPI | 1568414555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER JAMES EVANS Doctor 843-669-2007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: SC 18276) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: SC 22902) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-08-22 |