Healthcare Provider Details

I. General information

NPI: 1659661536
Provider Name (Legal Business Name): CHRISTOPHER CAMERON MCCOY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2011
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 DOUG WHITE DR STE 210
MYRTLE BEACH SC
29572-4181
US

IV. Provider business mailing address

920 DOUG WHITE DR STE 210
MYRTLE BEACH SC
29572-4181
US

V. Phone/Fax

Practice location:
  • Phone: 843-497-6348
  • Fax: 843-497-6351
Mailing address:
  • Phone: 843-497-6348
  • Fax: 843-497-6351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number97352
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR6831
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: