Organization
COASTAL DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELE ANN MITTLEBRONN M.D. (BILLING/ CREDENTIALING)
(843) 881-2265
Entity
Organization
Contact information
Practice address
999 LAKE HUNTER CIR, MOUNT PLEASANT, SC 29464-5427
(843) 881-2265
(843) 881-2789
Mailing address
999 LAKE HUNTER CIR, MOUNT PLEASANT, SC 29464-5427
(843) 881-2265
(843) 881-2789
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
22838
SC
Other
Enumeration date
02/15/2008
Last updated
05/10/2011
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