Organization
DUNES PATHOLOGY, LLC
Active
Other names
Diagnostic Pathology, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES T WALLS JR. MD (OWNER/ MANAGER)
(843) 213-1790
Entity
Organization
Contact information
Practice address
915 MEDICAL CIR, MYRTLE BEACH, SC 29572-4116
(843) 213-1790
(843) 213-1830
Mailing address
PO BOX 70549, MYRTLE BEACH, SC 29572
(843) 213-1790
(843) 213-1830
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890127G
—
NC
01
—
CB4464
MEDICARE RAILROAD
SC
05
—
GP0614
—
SC
Enumeration date
02/03/2006
Last updated
07/21/2022
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