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Organization

COASTAL WOUND CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIMOTHY JAMES DURKAN GREGORY MD (PHYSICIAN/OWNER)
(254) 368-7864
Entity
Organization

Contact information

Practice address
2060 CHARLIE HALL BLVD STE A, CHARLESTON, SC 29414-6066
(843) 483-0193
(839) 213-4599
Mailing address
2060 CHARLIE HALL BLVD STE A, CHARLESTON, SC 29414-6066
(843) 483-0193
(839) 213-4599

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
331297
SC
Enumeration date
06/08/2023
Last updated
10/21/2024
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