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General NPI Number Information
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NPI Number | 1245408103
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Entity Type | Organization
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Legal Business Name | HILTON HEAD PSYCHIATRIC CLINICS, PC
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 03/08/2016
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Provider Practice Location Address
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Address Line | 60 MAIN ST SUITE H
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City | HILTON HEAD ISLAND
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State | SC
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Zip | 29926-6602
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Country | US
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Telephone | 843-681-1935
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Fax | 843-681-7546
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Provider Business Mailing Address
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Address Line | 60 MAIN ST SUITE H
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City | HILTON HEAD ISLAND
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State | SC
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Zip | 29926-6602
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Country | US
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Telephone | 843-681-1935
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Fax | 843-681-7546
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAVINDRA PRAKASH SRIVASTAVA
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Credential | M.D.
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Telephone | 843-681-1935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 23689
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License Number State | SC
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