Healthcare Provider Details

I. General information

NPI: 1295794428
Provider Name (Legal Business Name): DELFIN FERDINAND VALITE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 CHERAW STREET
BENNETTSVILLE SC
29512-2422
US

IV. Provider business mailing address

PO BOX 918
BENNETTSVILLE SC
29512-0918
US

V. Phone/Fax

Practice location:
  • Phone: 843-454-0841
  • Fax: 843-454-0635
Mailing address:
  • Phone: 803-327-4357
  • Fax: 803-324-4357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number22946
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: