Individual
GAVIN MICHAEL VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4040 HIGHWAY 17, MURRELLS INLET, SC 29576-5098
(843) 652-8160
(843) 652-8161
Mailing address
PO BOX 1209, MURRELLS INLET, SC 29576-1209
(843) 652-8220
(843) 527-7080
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
37356
SC
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
37356
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TL37356
MEDICAL LICENSE
SC
Enumeration date
09/01/2006
Last updated
11/06/2014
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