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Contact Information

MYRTLE BEACH DERMATOLOGY
1275 21ST AVE N BLDG 2
MYRTLE BEACH, SC29577-7514
 Phone: 843-449-9140
 Fax: 843-497-5110
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for MYRTLE BEACH DERMATOLOGY · (Female)

NPI # 1285683003
Status Active
Credentials
Entity Individual
Enumeration date 05/09/2006
Last updated 08/20/2024 - More than a year ago
Sole proprietor 1 Not specified
Identifiers
  • SC License # 19296
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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