Healthcare Provider Details

I. General information

NPI: 1144858291
Provider Name (Legal Business Name): ANTHONY RAYMOND KHOURY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 N KINGS HWY
MYRTLE BEACH SC
29572-3055
US

IV. Provider business mailing address

7900 N KINGS HWY
MYRTLE BEACH SC
29572-3055
US

V. Phone/Fax

Practice location:
  • Phone: 843-449-3381
  • Fax:
Mailing address:
  • Phone: 843-449-3381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number97280
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: