Organization
COASTAL OBSTETRICS AND GYNECOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ARDRA DAVIS-TOLBERT MD (DIRECTOR)
(843) 521-0377
Entity
Organization
Contact information
Practice address
13 MARSHELLEN DRIVE, BEAUFORT, SC 29902
(843) 521-0377
(843) 525-9194
Mailing address
13 MARSHELLEN DR, BEAUFORT, SC 29902
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22002
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4001
—
SC
Enumeration date
12/22/2006
Last updated
04/18/2012
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