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Organization

COASTAL CAROLINA INFECTIOUS DISEASE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARLENE THORNHILL (BILLING MANAGER)
(843) 668-2376
Entity
Organization

Contact information

Practice address
1110 LONDON ST STE 102, MYRTLE BEACH, SC 29577
(843) 668-2376
(843) 748-0613
Mailing address
1110 LONDON ST STE 102, MYRTLE BEACH, SC 29577-5799
(843) 668-2376
(843) 748-0613

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
SC

Other

Enumeration date
01/07/2016
Last updated
05/17/2018
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