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COLORECTAL SURGERY CLINIC LLC NPI 1386916450


NPI Information

NPI: 1386916450
Provider Name: COLORECTAL SURGERY CLINIC, LLC
Classification: Colon & Rectal Surgery - 208C00000X
Entity Type: Organization

CLIA Number: 42D2048993

Address:
1439 STUART ENGALS BLVD
SUITE 100
MT PLEASANT, SC
ZIP 29464
Phone: (843) 853-7730
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COLORECTAL SURGERY CLINIC, LLC is a colon rectal surgery in Mt Pleasant, SC. The provider is a colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. COLORECTAL SURGERY CLINIC, LLC NPI is 1386916450. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1439 STUART ENGALS BLVD
SUITE 100
MT PLEASANT, SC
ZIP 29464-686
Phone: (843) 853-7730
Fax: (843) 722-8766

The provider's authorized official is Maria Margarita Murphy .
The authorized official title is Co-owner and has the following contact phone number (843) 853-7730.

The CLIA number assigned to this NPI record is 42D2048993 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/3/2012 and was last updated on 3/8/2012.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208C00000XColon & Rectal SurgeryMD 28532SOUTH CAROLINAYes

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: 5/5/2024

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