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General NPI Number Information
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NPI Number | 1457143091
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Entity Type | Organization
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Legal Business Name | COASTAL RENAL CARE
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 929 MEDICAL CIR
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City | MYRTLE BEACH
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State | SC
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Zip | 29572-4116
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Country | US
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Telephone | 843-999-5042
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Fax | 843-839-0018
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Provider Business Mailing Address
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Address Line | 929 MEDICAL CIR
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City | MYRTLE BEACH
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State | SC
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Zip | 29572-4116
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Country | US
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Telephone | 843-999-5042
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Fax | 843-839-0018
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Authorized Official
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Title or Position | OWNER/MD
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Name | KARANDEEP SINGH SHERGILL
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Credential | MD
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Telephone | 843-497-5929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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