Individual
DR. MICHAEL P GAMBACORTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
100 LEGENDS RD, STE A, MYRTLE BEACH, SC 29579-7076
(843) 236-9090
(843) 236-9099
Mailing address
100 LEGENDS RD STE A, MYRTLE BEACH, SC 29579-7076
(843) 236-9090
(843) 236-9099
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
28968
SC
363L00000X
Nurse Practitioner
Primary
28968
SC
Other
Enumeration date
06/02/2005
Last updated
01/15/2025
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