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Coastal Grande Ob-gyn,llc
Specialist in Myrtle Beach, South Carolina
NPI 1811935463

Coastal Grande Ob-gyn,llc is a Specialist based in Myrtle Beach, SC. Coastal Grande Ob-gyn,llc practices in Myrtle Beach, SC. The NPI Number for Coastal Grande Ob-gyn,llc is 1811935463 and holds a License No. (South Carolina).

The current practice location address for Coastal Grande Ob-gyn,llc is 1021 Cipriana Drive, Myrtle Beach, SC and can be reached out via phone at 843-421-8200 and via fax at 843-839-3634.

Location: 1021 Cipriana Drive, Myrtle Beach, SC, 29572-4619
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1811935463
Provider Name
Coastal Grande Ob-gyn,llc
Credential
Provider Entity Type
Organization
Address
1021 Cipriana Drive, Myrtle Beach, SC, 29572-4619
Phone Number
843-421-8200
Fax Number
843-839-3634
Provider Enumeration Date
06/04/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
GP4188 05 SC
institution
Provider Business Practice Location Address Details
Address
1021 Cipriana Drive
City
Myrtle Beach
State
South Carolina
Zip
29572-4619
Phone Number
843-421-8200
Fax Number
843-839-3634
person
Provider Business Mailing Address Details
Address
1021 Cipriana Drive
City
Myrtle Beach
State
South Carolina
Zip
29572-4619
Phone Number
843-421-8200
Fax Number
843-839-3634
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
(South Carolina)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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