Coastal Dermatology Institute LLC
NPI #1174122444 in Myrtle Beach, South Carolina
Provider Information
- NPI Number
- 1174122444
- Entity Type
- Organization
- Organization Name
- Coastal Dermatology Institute LLC
- Primary Specialty
- Dermatology - MOHS-Micrographic Surgery
- Enumeration Date
- Oct 19, 2020
- Last Updated
- Jun 2, 2021
Practice Location
- Address
- 199 VILLAGE CENTER BLVD STE 200
- City
- Myrtle Beach
- State
- South Carolina
- ZIP Code
- 29579-3589
- Phone
- (843) 738-0500
Authorized Official
- Name
- MICHAEL CENTILLI, DO
- Title
- OWNER
- Phone
- (517) 203-6532
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dermatology - MOHS-Micrographic Surgery — MOHS-Micrographic Surgery |
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