GRAND STRAND PLASTIC & RECONSTRUCTIVE SURGERY CENTER PA NPI 1619157294

NPI Information

GRAND STRAND PLASTIC & RECONSTRUCTIVE SURGERY CENTER PA 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 PLASTIC & RECONSTRUCTIVE SURGERY CENTER PA NPI is 1619157294. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4610 OLEANDER DR
SUITE 101
MYRTLE BEACH, SC
ZIP 29577-752
Phone: (843) 497-2227
Fax: (843) 449-9265

The provider's authorized official is Lisa J Pierce .
The authorized official title is Business Manager and has the following contact phone number (843) 497-2227.

The enumeration date for this NPI number is 11/12/2007 and was last updated on 9/30/2013.

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:

Other Identifiers

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

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