MEDICARE: EAST COOPER PLASTIC SURGERY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	18425	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558540567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST COOPER PLASTIC SURGERY LLC

Provider Business Mailing Address
First Line	:	1240 HOSPITAL DR
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3251
Country	:	US
Telephone Number	:	843-849-8418
Fax Number	:

Provider Business Practice Location Address
First Line	:	1240 HOSPITAL DR
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3251
Country	:	US
Telephone Number	:	843-849-8418
Fax Number	:	843-849-8419

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD M KLINE JR.
Credential	:	M.D.
Telephone Number	:	843-849-8418

Provider Enumeration Date	:	10/25/2007
Last Update Date	:	01/29/2026

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Directions to “EAST COOPER PLASTIC SURGERY LLC ” Practice Location

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