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Physicians Psychiatry & Neurology Neurology

Provider NPI: 1225246184

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 843-792-1414  Fax: --

Business Mailing Address:
PO BOX 751461  CHARLOTTE, NC 28275-1461 US
Tel: --  Fax: --

NPI Information:
NPI: 1225246184
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Psychiatry & Neurology
Psychiatry & Neurology
Psychiatry & Neurology

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 2084N0400X





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