Healthcare Provider Details
I. General information
NPI: 1932159811
Provider Name (Legal Business Name): PERRY E TROUCHE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/11/2006
Last Update Date: 05/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9229 UNIVERSITY BLVD STE 2-B
NORTH CHARLESTON SC
29406-9150
US
IV. Provider business mailing address
9229 UNIVERSITY BLVD STE 2-B
NORTH CHARLESTON SC
29406-9150
US
V. Phone/Fax
- Phone: 843-572-9800
- Fax: 843-572-9893
- Phone: 843-572-9800
- Fax: 843-572-9893
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 9614 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: