Healthcare Provider Details
I. General information
NPI: 1366708992
Provider Name (Legal Business Name): MICHAEL BENJAMIN MEFFORD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/09/2012
Last Update Date: 12/06/2025
Certification Date: 12/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
159 CIVITAS ST STE 203
MOUNT PLEASANT SC
29464-2201
US
IV. Provider business mailing address
159 CIVITAS ST STE 203
MOUNT PLEASANT SC
29464-2201
US
V. Phone/Fax
- Phone: 843-977-2677
- Fax: 843-829-4770
- Phone: 843-977-2677
- Fax: 843-829-4770
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | MD18623 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: