DIABETES CLINIC OF THE COAST PLLC NPI 1538532221

NPI Information

DIABETES CLINIC OF THE COAST, PLLC is a family nurse practitioner in Gulfport, MS. DIABETES CLINIC OF THE COAST, PLLC NPI is 1538532221. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1110 BROAD AVE
SUITE 600
GULFPORT, MS
ZIP 39501-907
Phone: (228) 220-1588
Fax: (228) 220-1581

The provider's authorized official is Melonie R Roberts .
The authorized official title is Owner and has the following contact phone number (228) 697-8244.

The enumeration date for this NPI number is 11/4/2015 and was last updated on 11/4/2015.

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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