Provider Demographics
NPI:1518437110
Name:HANLEY, DAVID PATRICK
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PATRICK
Last Name:HANLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10698 OCEAN HIGHWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585
Mailing Address - Country:US
Mailing Address - Phone:843-979-3273
Mailing Address - Fax:843-979-3275
Practice Address - Street 1:10698 OCEAN HIGHWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585
Practice Address - Country:US
Practice Address - Phone:843-979-3273
Practice Address - Fax:843-979-3275
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCIHCP-0833251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
82-2829953OtherFE-IN