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Organization
GRANDE DUNES OBGYN AND FACIAL AESTHETICS PA
Active
Organization
GRANDE DUNES OBGYN AND FACIAL AESTHETICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TATIANA LEYEN VU-MOLASCHI MD (OWNER)
(843) 839-2229
Entity
Organization
Contact information
Practice address
913 MEDICAL CIR, MYRTLE BEACH, SC 29572-4116
(843) 839-2229
(843) 839-2230
Mailing address
913 MEDICAL CIR, MYRTLE BEACH, SC 29572-4116
(843) 839-2229
(843) 839-2230
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278586
—
SC
Enumeration date
04/30/2014
Last updated
09/14/2023
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