MEDICARE: MARI ELISABETH ASPER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	MMD29858	SC

General Provider Information

NPI Number	:	1073710786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARI ELISABETH ASPER MD

Provider Business Mailing Address
First Line	:	9263 MEDICAL PLAZA DR. STE. A
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406
Country	:	US
Telephone Number	:	843-377-1600
Fax Number	:	843-377-1601

Provider Business Practice Location Address
First Line	:	9263 MEDICAL PLAZA DR. STE. A
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406
Country	:	US
Telephone Number	:	843-377-1600
Fax Number	:	843-377-1601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	04/28/2017

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