Healthcare Provider Details

I. General information

NPI: 1033591979
Provider Name (Legal Business Name): EBELE COMPEAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2015
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 TRAIL RIDGE RD 1ST FLOOR (PRIVATE OFFICE 125)
AIKEN SC
29803
US

IV. Provider business mailing address

900 TRAIL RIDGE RD
AIKEN SC
29803-7765
US

V. Phone/Fax

Practice location:
  • Phone: 833-351-8255
  • Fax:
Mailing address:
  • Phone: 833-351-8255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD38502
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number202002025
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number85594
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: