Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgery, Foot & Ankle |
213ES0103X | 48 | Podiatry |
| NPI Number | 1184278335 |
| LBN Legal business name | COASTAL CAROLINA HEALTH CARE, PA |
| Authorized official | STEPHEN NUCKOLLS - (CEO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/26/2019 |
| Last updated | 08/16/2024 - More than a year ago |
| Identifiers | n/a |
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