Coastal Family Medicine

LBN: Coastal Family Medicine
Coastal Family Medicine is an health care organization with primary practice located at 8014 Myrtle Trace Dr , Conway SC 29526-8945. The organization recently has only one registered license in Other Service Providers / Legal Medicine, which is considered as the primary health care specialty. Coastal Family Medicine can be contacted via phone (843) 347-7224, or through Dieter, Jonathan L via phone (843) 347-7224.

Contact Information

Primary practice address
8014 Myrtle Trace Dr Conway SC 29526-8945
Phone: (843) 347-7224
Fax: (843) 347-7335
Website:
Map and Directions
Authorized official contact:
Name: Dieter, Jonathan L Doctor of Medicine (MD)
Phone: (843) 347-7224

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X MD 7055 South Carolina

Profile Details

NPI number 1548459597
LBN Legal business name Coastal Family Medicine
DBA Doing business as
Authorized official Dieter, Jonathan L Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 16th, 2007
Last updated Oct 17th, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548459597 NPPES
South Carolina Other 2958 MEDICARE PROVIDER NUMBER
South Carolina Other PC4269 MEDICARE PROVIDER NUMBER

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