National Provider Identifier Database

COASTAL CAROLINA SURGICAL ASSOC
Vascular Surgery

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.


Contact Information

COASTAL CAROLINA SURGICAL ASSOC
1055 RIBAUT ROAD
SUITE 30
BEAUFORT, SC29902-5447
Phone: 843-524-8171
Fax: 843-525-6613
Website:
Specialty Taxonomy Code
* Vascular Surgery 2086S0129X
Surgery 208600000X

* Indicates primary specialty

NPI Profile & details for COASTAL CAROLINA SURGICAL ASSOC

NPI Number 1831252477
Legal business name
LBN
COASTAL CAROLINA SURGICAL ASSOC
Authorized official LORI MOCK - (PRACTICE ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 12/18/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor1 Not specified
Identifiers n/a

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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