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Contact Information

COASTAL CAROLINA OTOLARYNGOLOGY ASSOCIATES,PA
3822 MAYFAIR ST
MYRTLE BEACH, SC29577-0912
 Phone: 843-449-6449
 Fax: 843-449-1069
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery within the Head & Neck

207YX0007X 04 Physician/Otolaryngology
 

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for COASTAL CAROLINA OTOLARYNGOLOGY ASSOCIATESPA · (Female)

NPI # 1497717086
Status Active
Credentials
Entity Individual
Enumeration date 04/06/2006
Last updated 08/26/2025 - About 9 months ago
Sole proprietor 1 Not specified
Identifiers
  • SC Medicaid GP0566
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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