Organization
INLET PHYSICAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG STEVEN COHEN (OWNER)
(843) 652-5678
Entity
Organization
Contact information
Practice address
804 INLET SQUARE DR UNIT B, MURRELLS INLET, SC 29576-7874
(843) 652-5678
(843) 652-5679
Mailing address
804 INLET SQUARE DR UNIT B, MURRELLS INLET, SC 29576-7874
(843) 652-5678
(843) 652-5679
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
30634
SC
208VP0014X
Interventional Pain Medicine Physician
Primary
30634
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A843
MEDICARE PTAN
SC
Enumeration date
02/03/2012
Last updated
09/23/2013
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