Healthcare Provider Details
I. General information
NPI: 1851464457
Provider Name (Legal Business Name): THE INSTITUTE FOR NEURODEVELOPMENTAL PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
305 E CHEVES ST MCLEOD MEDICAL PARK WEST, SUITE 330
FLORENCE SC
29506-2610
US
IV. Provider business mailing address
305 E CHEVES ST MCLEOD MEDICAL PARK WEST, SUITE 330
FLORENCE SC
29506-2610
US
V. Phone/Fax
- Phone: 843-777-5770
- Fax: 843-777-5772
- Phone: 843-777-5770
- Fax: 843-777-5772
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0006X |
| Taxonomy | Developmental - Behavioral Pediatrics Physician |
| License Number | 12114 |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0008X |
| Taxonomy | Pediatric Neurodevelopmental Disabilities Physician |
| License Number | 12114 |
| License Number State | SC |
VIII. Authorized Official
Name: DR.
FRANK
R
BROWN
III
Title or Position: DIRECTOR
Credential: M.D.
Phone: 843-777-5770