# COASTAL PEDIATRIC ASSOCIATES, PA

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

## Provider details

- **NPI number:** 1851680896
- **Authorized official:** DR. WILLIAM MCLAURIN GRAHAM MD (PRESIDENT)
- **Authorized official phone:** (843) 573-2535

## Contact information

- **Practice address:** 1952 LONG GROVE DR, SUITE 202, MOUNT PLEASANT, SC 29464-7579
- **Practice address phone:** (843) 284-4262
- **Mailing address:** 2051 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5834
- **Mailing address phone:** (843) 266-4769

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 18368 | SC | Yes |

## Other

- **Enumeration date:** 03/30/2011
- **Last updated:** 02/22/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP4680 | — | SC |
| 05 | — | GP4716 | — | SC |