Individual
DR. DEREK DAVID KESTILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6010 HIGHWAY 707, STE 100, MYRTLE BEACH, SC 29588-7321
(843) 234-8939
(843) 234-8959
Mailing address
300 SINGLETON RIDGE ROAD, ATTENTION PNS CREDENTIALING, CONWAY, SC 29526-9142
(843) 234-6946
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
83469
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
834690
—
SC
Enumeration date
07/03/2013
Last updated
05/10/2024
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