Organization
COASTAL INTERNAL MEDICINE & GERIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADHAVI AKKINENI M.D. (OWNER)
(843) 466-8000
Entity
Organization
Contact information
Practice address
597 OLD MOUNT HOLLY RD, STE 202, GOOSE CREEK, SC 29445-2831
(843) 466-8000
Mailing address
597 OLD MOUNT HOLLY RD, STE 202, GOOSE CREEK, SC 29445-2831
(843) 466-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33988
SC
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
33988
SC
Other
Enumeration date
04/16/2017
Last updated
04/16/2017
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