Organization
COASTAL GRAND OBGYN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH SPIELVOGEL M.D. (OWNER/M.D.)
(843) 421-8200
Entity
Organization
Contact information
Practice address
1021 MEDICAL CIR, SUITE 250, MYRTLE BEACH, SC 29572-4619
(843) 421-8200
(843) 839-3634
Mailing address
1021 MEDICAL CIR, SUITE 250, MYRTLE BEACH, SC 29572-4619
(843) 421-8200
(843) 839-3634
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
222100
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4188
—
SC
Enumeration date
12/18/2006
Last updated
02/13/2008
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