# COASTAL MEDSURG, INC.

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

## Provider details

- **NPI number:** 1861969164
- **Authorized official:** EDWARD WILSON CSA, RSA (PRESIDENT)
- **Authorized official phone:** (757) 672-3738

## Contact information

- **Practice address:** 1700 WILL O WISP DR, VIRGINIA BEACH, VA 23454-3164
- **Practice address phone:** (757) 496-6400
- **Mailing address:** 604 BISHOP DR, VIRGINIA BEACH, VA 23455-6544

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | — | NULL | Yes |
| 363AS0400X | Surgical Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 10/25/2018
- **Last updated:** 10/25/2018