Organization
CAROLINA REGIONAL CANCER CENTER LLC
Active
Other names
Carolina Regional Cancer Center Inc
Organization subpart
No
Provider details
NPI number
Authorized official
SHADEN MARZOUK (PRESIDENT)
(239) 931-7254
Entity
Organization
Contact information
Practice address
4708 OLEANDER DRIVE, MYRTLE BEACH, SC 29577
(843) 449-9415
(843) 449-2160
Mailing address
1419 SE 8TH TER STE 200, CAPE CORAL, FL 33990-3213
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02260
BCBS
NC
01
—
503356
BCBS
PA
05
—
8902260
—
NC
01
—
9620580
GHI
—
01
—
CG7705
RAILROAD MEDICARE
—
05
—
GP0968
—
SC
Enumeration date
05/13/2006
Last updated
09/25/2023
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