Individual
DR. MICHAEL ROBERT CENTILLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
199 VILLAGE CENTER BLVD STE 200, MYRTLE BEACH, SC 29579-3589
(843) 738-0500
(437) 380-5058
Mailing address
199 VILLAGE CENTER BLVD STE 200, MYRTLE BEACH, SC 29579-3589
(843) 738-0500
(843) 738-0505
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
52108
SC
Other
Enumeration date
06/27/2011
Last updated
06/10/2021
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