Organization
COASTAL CAROLINA PHYSICIAN PRACTICES LLC
Active
Other names
Coastal Carolina Ear Nose and Throat
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT KLEIN (DIVISION PRESIDENT)
(615) 372-8500
Entity
Organization
Contact information
Practice address
1010 MEDICAL CENTER DR, SUITE 210, HARDEEVILLE, SC 29927-3447
(843) 784-7160
(843) 784-7161
Mailing address
1010 MEDICAL CENTER DR, SUITE 210, HARDEEVILLE, SC 29927-3447
(843) 784-7160
(843) 784-7161
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
18548
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
SC
Enumeration date
03/20/2007
Last updated
08/22/2020
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