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General NPI Number Information
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NPI Number | 1063121044
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Entity Type | Individual
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Provider Name | SEAN DONALD EBERHARD
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Gender | Male
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Dates
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Enumeration Date | 11/18/2022
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 2079 CHARLIE HALL BLVD
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City | CHARLESTON
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State | SC
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Zip | 29414-5834
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Country | US
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Telephone | 843-974-5622
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Fax |
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Provider Business Mailing Address
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Address Line | 3527 DUNMOVIN DR
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City | JOHNS ISLAND
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State | SC
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Zip | 29455-8421
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Country | US
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Telephone | 843-437-6511
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 244943
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 27151
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License Number State | SC
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