Organization
COASTAL CARDIOVASCULAR CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA MARIE HILLIARD (PRACTICE ADMINISTRATOR)
(843) 470-0256
Entity
Organization
Contact information
Practice address
990 RIBAUT RD, SUITE 102, BEAUFORT, SC 29902-5601
(843) 470-0256
(843) 470-0555
Mailing address
PO BOX 370, PORT ROYAL, SC 29935-0370
(843) 470-0256
(843) 470-0555
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
18820
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188200
—
SC
Enumeration date
06/09/2006
Last updated
12/05/2011
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