Doctor Name: | DR. EDWARD H CONNOR |
NPI Number: | 1013933852 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 3743 |
Business Practice Address: | 164 Waccamaw Medical Park Dr Conway, SC - 295268903 |
Business Phone Number: | 8433475060 |
Business Fax Number: | |
Mailing Address: | 262 Middle Gate Rd, MYRTLE BEACH |
State: | SC |
Postal Code: | 295725645 |
Phone Number: | 8432726717 |
Fax Number: | |
NPI Enumeration Date: | 07/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 3743 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |