# MEDICOS, P.A.

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

## Provider details

- **NPI number:** 1548024540
- **Authorized official:** DR. KENNETH SANTIAGO MD (PRESIDENT)
- **Authorized official phone:** (843) 796-7422

## Contact information

- **Practice address:** 506 2ND AVE N, NORTH MYRTLE BEACH, SC 29582-3012
- **Practice address phone:** (843) 796-7422
- **Practice address fax:** (877) 817-3832
- **Mailing address:** PO BOX 70157, MYRTLE BEACH, SC 29572-0021
- **Mailing address phone:** (843) 504-2121
- **Mailing address fax:** (843) 487-0123

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/09/2024
- **Last updated:** 03/20/2025