Coastal Carolina Ent, DO, PA
Otolaryngology, Facial Plastic Surgery in Little River, SC. Organization (NPI-2).
NPI number1386989028
StatusActive
Last updated in NPPESJun 17, 2024
Details
- NPI
- 1386989028
- Entity type
- Organization (NPI-2)
- Legal business name
- Coastal Carolina Ent, DO, PA
- Organization subpart
- Yes
- Enumeration date
- Dec 6, 2012
- Certification date
- Jun 17, 2024
- Last updated
- Jun 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207YS0123X | Otolaryngology, Facial Plastic Surgery | DO 1480 | SC | Yes |
Practice location
3806 Sawtell RdLittle River, SC 29566-7873
Phone 843-663-9090 · Fax 843-663-9091
Mailing address
302 Liberty StWhiteville, NC 28472-3714
Phone 910-914-0540 · Fax 910-914-0640
Authorized official
Wendy C. Paris
Insurance/Billing Specialist
9109140540
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