# COASTAL INTERNAL MEDICINE & GERIATRICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265966337
- **Authorized official:** MADHAVI AKKINENI M.D. (OWNER)
- **Authorized official phone:** (843) 466-8000

## Contact information

- **Practice address:** 597 OLD MOUNT HOLLY RD, STE 202, GOOSE CREEK, SC 29445-2831
- **Practice address phone:** (843) 466-8000
- **Mailing address:** 597 OLD MOUNT HOLLY RD, STE 202, GOOSE CREEK, SC 29445-2831
- **Mailing address phone:** (843) 466-8000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 33988 | SC | Yes |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | 33988 | SC | — |

## Other

- **Enumeration date:** 04/16/2017
- **Last updated:** 04/16/2017