NPI 1952006603 · live from the CMS NPI Registry
Austin Detavis
Psychiatry & Neurology, Neurology in Greer, SC. National Provider Identifier 1952006603, active.
NPI record
| NPI | 1952006603 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology 2084N0400X |
| Practice location | 109 Physicians Dr, Greer, SC 29650 |
| Practice phone | 864-797-8856 |
| Enumerated | April 3, 2023 |
| Last updated | July 12, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology primary | 2084N0400X | LL89914 (SC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.