Organization
COASTAL NEUROLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL MAZZEO M.D. (PRESIDENT)
(843) 522-1420
Entity
Organization
Contact information
Practice address
1833 N. PARIS AVENUE, PORT ROYAL, SC 29935-2029
(843) 522-1420
(843) 522-1460
Mailing address
1833 N. PARIS AVENUE, PORT ROYAL, SC 29935-2029
(843) 522-1420
(843) 522-1460
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1188
—
SC
Enumeration date
04/20/2006
Last updated
08/18/2025
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