Organization
COASTAL GYNECOLOGY AND OBSTETRICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARRY WADE BOATWRIGHT M.D. (PHYSICIAN)
(843) 571-0200
Entity
Organization
Contact information
Practice address
2093 HENRY TECKLENBURG DR, SUITE 304 EAST, CHARLESTON, SC 29414-5741
(843) 571-0200
(866) 848-8485
Mailing address
PO BOX 81060, CHARLESTON, SC 29416-1060
(843) 571-0200
(866) 848-8485
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
12402
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1725
—
SC
Enumeration date
11/01/2006
Last updated
09/25/2012
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