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Contact Information

COASTAL CAROLINA PODIATRY INC
299 MIDLAND PKWY # B
SUMMERVILLE, SC29485-8104
 Phone: 843-851-9069
 Fax: 843-871-8248
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for COASTAL CAROLINA PODIATRY INC · (Female)

NPI Number 1629282744
Status Active
Credentials
Entity Individual
Enumeration date 05/09/2007
Last updated 04/20/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • SC License # 0556
  • SC Medicaid PD5561
  • Other DF0094 RR MEDICARE
  • SC Other CM2497 RAIL ROAD
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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