Organization
BEAUFORT OPEN MRI, LLC
Active
Other names
Coastal MRI
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL MAZZEO M.D. (NEUROLOGIST)
(843) 522-1420
Entity
Organization
Contact information
Practice address
1319 LADYS ISLAND DR, PORT ROYAL, SC 29935-1153
(843) 524-6736
(843) 524-1386
Mailing address
1319 LADYS ISLAND DR, PORT ROYAL, SC 29935-1153
(843) 524-6736
(843) 524-1386
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
14702
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SL0059
—
SC
Enumeration date
04/12/2006
Last updated
02/06/2012
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