Organization
COASTAL ANESTHESIA ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL E KERNS M.D. (OWNER)
(843) 442-2486
Entity
Organization
Contact information
Practice address
14 BROUGHTON RD, CHARLESTON, SC 29407-7529
(843) 553-7070
(843) 553-2223
Mailing address
PO BOX 1465, LADSON, SC 29456-1465
(843) 553-7070
(843) 553-2223
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ4348
RR MEDICARE
SC
05
—
GP3306
—
SC
Enumeration date
05/16/2006
Last updated
07/20/2012
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