Organization
GRANDE DUNES OBGYN AND FACIAL AESTHETICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TATIANA LEYEN VU-MOLASCHI MD (OWNER)
(843) 839-2229
Entity
Organization
Contact information
Practice address
913 MEDICAL CIR, MYRTLE BEACH, SC 29572-4116
(843) 839-2229
(843) 839-2230
Mailing address
913 MEDICAL CIR, MYRTLE BEACH, SC 29572-4116
(843) 839-2229
(843) 839-2230
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278586
—
SC
Enumeration date
04/30/2014
Last updated
09/14/2023
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