MYRTLE BEACH SPINE CENTER PA NPI 1962764142

NPI Information

  • NPI: 1962764142
  • Provider Name: MYRTLE BEACH SPINE CENTER, PA
  • Classification: Physical Medicine & Rehabilitation - 2081N0008X
  • Specialization: Neuromuscular Medicine
  • Entity Type: Organization
  • Address: 100 LEGENDS RD SUITE A
    MYRTLE BEACH, SC
    ZIP 29579
  • Phone: (843) 236-9090

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NPI Details

MYRTLE BEACH SPINE CENTER, PA is a neuromuscular medicine physical medicine rehabilitation in Myrtle Beach, SC. The provider is a physician who specializes in neuromuscular medicine possesses specialized knowledge in the science, clinical evaluation and management of these disorders. This encompasses the knowledge of the pathology, diagnosis and treatment of these disorders at a level that is significantly beyond the training and knowledge expected of a general neurologist, child neurologist or physiatrist. MYRTLE BEACH SPINE CENTER, PA NPI is 1962764142. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

100 LEGENDS RD SUITE A
MYRTLE BEACH, SC
ZIP 29579-076
Phone: (843) 236-9090
Fax: (843) 236-9099

The provider's authorized official is Michael P Gambacorta .
The authorized official title is Owner and has the following contact phone number (843) 236-9090.

The enumeration date for this NPI number is 6/13/2012 and was last updated on 9/5/2024.

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
1111N00000XChiropractorNo
22081N0008XPhysical Medicine & RehabilitationNeuromuscular MedicineYes
3261QP2300XClinic/CenterPrimary CareNo

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: 11/21/2025

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