Organization
PIAVE PITISCI LAKE, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PIAVE PITISCI LAKE M.D. (OWNER)
(843) 881-6616
Entity
Organization
Contact information
Practice address
409 COLEMAN BLVD, MT PLEASANT, SC 29464-4391
(843) 881-6616
(843) 881-7617
Mailing address
409 COLEMAN BLVD, MT PLEASANT, SC 29464-4391
(843) 881-6616
(843) 881-7617
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
22627
SC
Other
Enumeration date
06/02/2010
Last updated
06/02/2010
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