Individual
RICHARD GRANT HIGHSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 497-5929
(843) 497-6601
Mailing address
4615 OLEANDER DR, SUITE 201A, MYRTLE BEACH, SC 29577-5741
(843) 449-9559
(843) 497-6601
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R8283
IA
207P00000X
Emergency Medicine Physician
Primary
TL33568
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TL33568
STATE MEDICAL LICENSE
SC
Enumeration date
05/19/2008
Last updated
08/09/2011
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