Healthcare Provider Details

I. General information

NPI: 1780889063
Provider Name (Legal Business Name): HAINES K PAIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 DOUG WHITE DR STE 130
MYRTLE BEACH SC
29572-4180
US

IV. Provider business mailing address

920 DOUG WHITE DR STE 130
MYRTLE BEACH SC
29572-4180
US

V. Phone/Fax

Practice location:
  • Phone: 843-848-1440
  • Fax: 843-839-1654
Mailing address:
  • Phone: 843-848-1440
  • Fax: 843-839-1654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number250504
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number87535
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: