Healthcare Provider Details

I. General information

NPI: 1972336311
Provider Name (Legal Business Name): BAY MICROSURGICAL UNIT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 VILLAGE CENTER BLVD
MYRTLE BEACH SC
29579
US

IV. Provider business mailing address

90 CEDAR LIGHT LN
LITTLE RIVER SC
29566-6978
US

V. Phone/Fax

Practice location:
  • Phone: 843-449-7115
  • Fax: 843-497-2960
Mailing address:
  • Phone: 843-280-8779
  • Fax: 843-280-6669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JAMIE J KNIGHT
Title or Position: ADMINISTRATOR
Credential:
Phone: 843-280-8779