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GRAND STRAND GYNECOLOGY NPI 1578623039


NPI Information

NPI: 1578623039
Provider Name: GRAND STRAND GYNECOLOGY
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
911 MEDICAL CIR
MYRTLE BEACH, SC
ZIP 29572
Phone: (843) 449-5553
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GRAND STRAND GYNECOLOGY is a specialist in Myrtle Beach, SC. The provider is 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. GRAND STRAND GYNECOLOGY NPI is 1578623039. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

911 MEDICAL CIR
MYRTLE BEACH, SC
ZIP 29572-116
Phone: (843) 449-5553
Fax: (843) 449-4453

The provider's authorized official is Benjamin J. Martin .
The authorized official title is Owner and has the following contact phone number (843) 449-5553.

The enumeration date for this NPI number is 12/12/2006 and was last updated on 8/12/2010.


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
1174400000XSpecialistYes

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
1C68828MEDICARE UPINSOUTH CAROLINA
2D18222MEDICARE UPINSOUTH CAROLINA
3H45198MEDICARE UPINSOUTH CAROLINA
47526MEDICARE ID-TYPE UNSPECIFIEDSOUTH CAROLINAGROUP #
5PA4575MEDICAIDSOUTH CAROLINA
6G38127MEDICARE UPINSOUTH 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: 4/28/2024

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