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Organization

COASTAL UROLOGY CENTER, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIMOTHY JOSEPH QUILLEN M.D. (PRESIDENT)
(843) 347-8765
Entity
Organization

Contact information

Practice address
394 SINGLETON RIDGE RD, CONWAY, SC 29526-9150
(843) 347-8765
(843) 347-3466
Mailing address
394 SINGLETON RIDGE RD, CONWAY, SC 29526-9150
(843) 347-8765
(843) 347-3466

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary

Other

Enumeration date
05/17/2006
Last updated
08/22/2020
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