Healthcare Provider Details

I. General information

NPI: 1235401340
Provider Name (Legal Business Name): MARI ASPER MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2012
Last Update Date: 03/01/2025
Certification Date: 03/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9263 MEDICAL PLAZA DR SUITE A
NORTH CHARLESTON SC
29406-7109
US

IV. Provider business mailing address

9263 MEDICAL PLAZA DR SUITE A
NORTH CHARLESTON SC
29406-7109
US

V. Phone/Fax

Practice location:
  • Phone: 843-377-1600
  • Fax: 843-277-1601
Mailing address:
  • Phone: 843-377-1600
  • Fax: 843-277-1601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number29858
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number29858
License Number StateSC

VIII. Authorized Official

Name: MARI ASPER
Title or Position: OWNER
Credential: MD
Phone: 843-377-1600