Coastal Family Medicine
NPI #1548459597 in Conway, South Carolina
Provider Information
- NPI Number
- 1548459597
- Entity Type
- Organization
- Organization Name
- Coastal Family Medicine
- Primary Specialty
- Legal Medicine
- Enumeration Date
- Oct 16, 2007
- Last Updated
- Oct 17, 2007
Practice Location
- Address
- 8014 MYRTLE TRACE DR
- City
- Conway
- State
- South Carolina
- ZIP Code
- 29526-8945
- Phone
- (843) 347-7224
Authorized Official
- Name
- JONATHAN L DIETER JR., MD
- Title
- OWNER
- Phone
- (843) 347-7224
Specialties & Taxonomy Codes
| Specialty |
|---|
| Legal Medicine |
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