Organization
COASTAL PEDIATRIC ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA WOLF (DIRECTOR OF QUALITY PROGRAMS)
(843) 284-4258
Entity
Organization
Contact information
Practice address
2051 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5834
(843) 737-9467
(843) 371-5507
Mailing address
2051 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5834
(843) 737-9467
(843) 371-5507
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
—
—
Other
Enumeration date
03/30/2018
Last updated
03/30/2018
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