ANGELIC HEALTH PRACTICE GROUP NPI 1891448064

NPI Information

  • NPI: 1891448064
  • Provider Name: ANGELIC HEALTH PRACTICE GROUP
  • Classification: Nurse Practitioner - 363LC1500X
  • Specialization: Community Health
  • Entity Type: Organization
  • Doing Business As: ANGELIC PALLIATIVE CARE OF SC
  • CLIA Number: 42D2257229
  • Address: 923C MEDICAL CIRCLE
    MYRTLE BEACH, SC
    ZIP 29572
  • Phone: (843) 356-9078

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NPI Details

ANGELIC HEALTH PRACTICE GROUP is a community health nurse practitioner in Myrtle Beach, SC. ANGELIC HEALTH PRACTICE GROUP NPI is 1891448064. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Angelic Palliative Care Of Sc.

The provider's business location address is:

923C MEDICAL CIRCLE
MYRTLE BEACH, SC
ZIP 29572
Phone: (843) 356-9078
Fax: (843) 356-4086

The provider's authorized official is Dan Mikus .
The authorized official title is Ceo and has the following contact phone number (609) 822-7979.

The CLIA number assigned to this NPI record is 42D2257229 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/28/2022 and was last updated on 1/12/2024.

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
11041C0700XSocial WorkerClinicalNo
2363LC1500XNurse PractitionerCommunity HealthYes

What is NPI?

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This page was last updated on: 11/21/2025

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