# COASTAL FAMILY MEDICINE, PC

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

## Provider details

- **NPI number:** 1548662042
- **Authorized official:** DANIEL MILLER M.D. (CFO)
- **Authorized official phone:** (912) 267-4900

## Contact information

- **Practice address:** 390 EH CT, BRUNSWICK, GA 31520-2198
- **Practice address phone:** (912) 267-4900
- **Practice address fax:** (912) 267-4960
- **Mailing address:** 390 EH CT, BRUNSWICK, GA 31520-2198
- **Mailing address phone:** (912) 267-4900
- **Mailing address fax:** (912) 267-4960

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 46996 | GA | Yes |

## Other

- **Enumeration date:** 09/16/2014
- **Last updated:** 09/16/2014