| Doctor Name: | MR. ASUQUO O. EDEM |
| NPI Number: | 1437101011 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 2244 Browntown Rd Bishopville, SC - 290109664 |
| Business Phone Number: | 8034286052 |
| Business Fax Number: | 8034285406 |
| Mailing Address: | 215 N. Magnolia St., Swcmhc SUMTER |
| State: | SC |
| Postal Code: | 291511946 |
| Phone Number: | 8037759364 |
| Fax Number: | 8037736615 |
| NPI Enumeration Date: | 05/16/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP1600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Pastoral |
| Taxonomy Definition: | |