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COASTAL PHYSICAL MEDICINE PA NPI 1053580662


NPI Information

NPI: 1053580662
Provider Name: COASTAL PHYSICAL MEDICINE, PA
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
3185 AZALEA DR
NORTH CHARLESTON, SC
ZIP 29405
Phone: (843) 762-2274
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COASTAL PHYSICAL MEDICINE, PA is a medical specialty clinic center in North Charleston, SC. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). COASTAL PHYSICAL MEDICINE, PA NPI is 1053580662. The provider is registered as an organization entity type.

The provider's business location address is:

3185 AZALEA DR
NORTH CHARLESTON, SC
ZIP 29405-211
Phone: (843) 762-2274
Fax: (843) 762-2278

The provider's authorized official is Rebecca Mcswain .
The authorized official title is Practice Manager and has the following contact phone number (843) 762-2274.

The enumeration date for this NPI number is 2/27/2008 and was last updated on 2/27/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2500XClinic/CenterMedical Specialty19612SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GP2989MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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