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General NPI Number Information
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NPI Number | 1750981833
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Entity Type | Individual
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Provider Name | KAITLYN MARIE MCGUIGAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/28/2020
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | GRAND STRAND PEDIATRICS 1120 GLENNS BAY ROAD
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City | SURFSIDE BEACH
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State | SC
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Zip | 29575
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Country | US
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Telephone | 843-449-1438
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Fax | 843-286-1349
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Provider Business Mailing Address
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Address Line | GRAND STRAND PEDIATRICS 8120 ROURK STREET
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City | MYRTLE BEACH
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State | SC
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Zip | 29572
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Country | US
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Telephone | 843-449-1438
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Fax | 843-286-1349
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 3619
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License Number State | SC
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