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General NPI Number Information
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NPI Number | 1922593854
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Entity Type | Individual
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Provider Name | COREY HASSELL MD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2018
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 115 FAIRCHILD ST STE 170
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City | DANIEL ISLAND
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State | SC
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Zip | 29492-7602
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Country | US
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Telephone | 803-339-1563
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Fax | 803-746-7902
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Provider Business Mailing Address
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Address Line | 115 FAIRCHILD ST STE 170
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City | DANIEL ISLAND
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State | SC
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Zip | 29492-7602
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Country | US
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Telephone | 803-339-1563
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Fax | 803-746-7902
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | LL52800
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License Number State | SC
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