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NPI Code Detail

MEDICARE: COASTAL CARDIOLOGY, P.A.

MEDICARE: COASTAL CARDIOLOGY, P.A.
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
1207RC0000XCardiovascular Disease Physician

Other Identifiers

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

General Provider Information

NPI Number : 1881645893
Entity Type Code : Organization
Provider Name (Legal Business Name) : COASTAL CARDIOLOGY, P.A.
Provider Business Mailing Address
First Line : 1033 SAINT ANDREWS BLVD
Second Line :
City : CHARLESTON
State : SC
Zip : 29407-7156
Country : US
Telephone Number : 843-723-6111
Fax Number : 843-727-0973
Provider Business Practice Location Address
First Line : 1033 SAINT ANDREWS BLVD
Second Line :
City : CHARLESTON
State : SC
Zip : 29407-7156
Country : US
Telephone Number : 843-723-6161
Fax Number : 843-723-0675
Authorized Official
Title or Position : COO
Name : VAN C. HENDRY
Credential :
Telephone Number : 843-377-1804
Provider Enumeration Date : 05/15/2006
Last Update Date : 03/03/2020

Similar Medicare Providers

1053267104 — DUANE NALDO FROES AGACNP
Practice Location Address:
1033 SAINT ANDREWS BLVD
CHARLESTON, SC
29407-7156
Practice Phone: 843-723-6111
Practice Fax: 843-727-2973
1568455723 — DR. SCOTT LATIMER WOODFIELD M.D., FACC
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1821054537 — DR. LARS HOKAN RUNQUIST MD
Practice Location Address:
1033 SAINT ANDREWS BLVD
CHARLESTON, SC
29407-7156
Practice Phone: 843-723-6111
Practice Fax: 843-727-2973
1255397519 — DR. JEFFREY STEWART RIEDER MD
Practice Location Address:
1033 SAINT ANDREWS BLVD
CHARLESTON, SC
29407-7156
Practice Phone: 843-723-6111
Practice Fax: 843-723-0675
1356307318 — DR. WILLIAM BLOUNT ELLISON JR. M.D.
Practice Location Address:
1033 SAINT ANDREWS BLVD
CHARLESTON, SC
29407-7156
Practice Phone: 843-723-6111
Practice Fax: 843-723-0675
1225083702 — MR. WILLIAM D. YARBROUGH M.D.
Practice Location Address:
1033 SAINT ANDREWS BLVD
CHARLESTON, SC
29407-7156
Practice Phone: 843-723-6111
Practice Fax: 843-727-2973

Directions to “COASTAL CARDIOLOGY, P.A. ” Practice Location

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