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General NPI Number Information
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NPI Number | 1952530727
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Entity Type | Organization
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Legal Business Name | UNITED HEALTHCARE PC
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | 130 BROAD ST
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City | SUMTER
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State | SC
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Zip | 29150-4237
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Country | US
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Telephone | 803-774-4377
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Fax |
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Provider Business Mailing Address
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Address Line | 130 BROAD ST
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City | SUMTER
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State | SC
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Zip | 29150-4237
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Country | US
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Telephone | 803-774-4377
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. TERRANCE WELLS
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Credential | LPC-I
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Telephone | 803-316-9056
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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 | 9114
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License Number State | SC
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