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Contact Information

COASTAL PEDIATRIC ASSOCIATES, P.A.
2067 CHARLIE HALL BLVD
CHARLESTON, SC29414-5834
 Phone: 843-573-2535
 Fax: 843-573-2534
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Health Service

103TH0100X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for COASTAL PEDIATRIC ASSOCIATES PA · (Female)

NPI # 1770700759
Status Active
Credentials
Entity Individual
Enumeration date 04/19/2007
Last updated 08/02/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers
  • SC Medicaid GP4680
  • SC Medicaid GP4716
  • SC Medicaid GP7882
  • SC Medicaid GP8203
  • SC Medicaid GP8228
  • SC Medicaid GP8229
  • SC Medicaid GP8237
  • SC Medicaid PG1066
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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