| NPI | 1588318125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD TAVEL Medical Director 843-408-0386 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology Pain Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2022-02-11 |
| Last Update Date | 2022-02-11 |