Coastal Grand Obgyn Pc

NPI 1083777486 - Specialist - 174400000X

NPI Details
NPI 1083777486
Enumeration Date 12/18/2006
Last Updated 02/13/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name KENNETH KENNETH
Position OWNER/M.D.
Phone (843) 421-8200
Fax (843) 839-3634
Practice Location
1021 MEDICAL CIR
SUITE 250
MYRTLE BEACH SC, 29572-4619, US
Phone (843) 421-8200
Fax (843) 839-3634
Business Location
1021 MEDICAL CIR
SUITE 250
MYRTLE BEACH SC, 29572-4619, US
Phone (843) 421-8200
Fax (843) 839-3634
Toxanomy
Taxonomy Code 174400000X
License State South Carolina
License Number 222100
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According to our database, Coastal Grand Obgyn Pc NPI is 1083777486, taxonomy code is 174400000X and license number is 222100, license state is located at South Carolina. Coastal Grand Obgyn Pc physically located at 1021 Medical Cir, Myrtle Beach SC, 29572-4619. NPI Number 1033115704 has the healthcare provider type.

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1083777486 NPI number is provided on an as is basis without warranty of any kind. 1083777486 is maintained by the National Plan & Provider Enumeration System. The contents of Coastal Grand Obgyn Pc are for informational purposes only.