National Provider Identifier Database

COASTAL CAROLINA OTOLARYNGOLOGY ASSOCIATESPA
Plastic Surgery within the Head & Neck

An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.


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
* Plastic Surgery within the Head & Neck 207YX0007X
Otolaryngology 207Y00000X

* Indicates primary specialty

NPI Profile & details for COASTAL CAROLINA OTOLARYNGOLOGY ASSOCIATES,PA

NPI Number 1497717086
Legal business name
LBN
COASTAL CAROLINA OTOLARYNGOLOGY ASSOCIATES,PA
Authorized official DANIEL ROSNER - (VICE PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 04/06/2006
Last updated 08/26/2025 - About 9 months ago
Sole proprietor1 Not specified
Identifiers
  • SC Medicaid: GP0566

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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