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COASTAL DERMATOLOGY INSTITUTE LLC NPI 1174122444


NPI Information

NPI: 1174122444
Provider Name: COASTAL DERMATOLOGY INSTITUTE LLC
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 42D2228091

Address:
199 VILLAGE CENTER BLVD STE 200
MYRTLE BEACH, SC
ZIP 29579
Phone: (843) 738-0500
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COASTAL DERMATOLOGY INSTITUTE LLC is a mohs-micrographic surgery dermatology in Myrtle Beach, SC. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. COASTAL DERMATOLOGY INSTITUTE LLC NPI is 1174122444. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

199 VILLAGE CENTER BLVD STE 200
MYRTLE BEACH, SC
ZIP 29579-589
Phone: (843) 738-0500

The provider's authorized official is Michael Centilli .
The authorized official title is Owner and has the following contact phone number (517) 203-6532.

The CLIA number assigned to this NPI record is 42D2228091 - physician office with a certificate type of Certificate of Registration.

The enumeration date for this NPI number is 10/19/2020 and was last updated on 6/2/2021.


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
1207ND0101XDermatologyMOHS-Micrographic SurgeryYes

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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