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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, P.A.

NPI # 1770700759
LBN Legal business name COASTAL PEDIATRIC ASSOCIATES, P.A.
Authorized official ROBERT CLIFFORD - (PARTNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/19/2007
Last updated 08/02/2022 - About 4 years ago
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
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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