Individual
YASHASWI KOGURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
809 82ND PKWY GRAND STAND MEDICAL CENTER, MYRTLE BEACH, SC 29572
(843) 692-1118
(843) 692-1122
Mailing address
809 82ND PKWY GRAND STAND MEDICAL CENTER, GME OFFICE, MYRTLE BEACH, SC 29572
(843) 692-1118
(843) 692-1122
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/07/2024
Last updated
09/20/2024
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