Organization
MT. PLEASANT PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD CANNON PHELPS II D.O. (PSYCHIATRIST)
(843) 400-4089
Entity
Organization
Contact information
Practice address
874 WHIPPLE RD STE 200, MT PLEASANT, SC 29464-8901
(843) 400-4089
(877) 832-2114
Mailing address
874 WHIPPLE RD STE 200, MT PLEASANT, SC 29464-8901
(843) 400-4089
(877) 832-2114
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
SC1442.MDO
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000556470
BLUE CROSS BLUE SHIELD
SC
Enumeration date
02/13/2012
Last updated
02/13/2012
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