Healthcare Provider Details

I. General information

NPI: 1649064114
Provider Name (Legal Business Name): MANISH MADAN LOKANDE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 04/08/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GRAND STRAND MEDICAL CENTER 809 82ND PARKWAY
MYRTLE BEACH SC
29572
US

IV. Provider business mailing address

GRAND STRAND MEDICAL CENTER - GME OFFICE 809 82ND PARKWAY
MYRTLE BEACH SC
29572
US

V. Phone/Fax

Practice location:
  • Phone: 843-848-4640
  • Fax: 843-839-2382
Mailing address:
  • Phone: 843-692-3497
  • Fax: 843-692-1122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateSC

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: