Organization · Type 2 NPI
Coastal Cancer Center LLC
Hematology & Oncology Physician · Loris, SC
Practice location
3008 Bayboro St
Loris, SC 29569-2714
Fax (843) 692-5015
Mailing address
8121 Rourk St
Myrtle Beach, SC 29572-4128
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Hematology & Oncology Physician Primary | 207RH0003X | 11181 (SC) |
| Durable Medical Equipment & Medical Supplies | 332B00000X | None listed |
Hematology & Oncology Physician: An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
About NPI 1205856556
Coastal Cancer Center LLC's National Provider Identifier is 1205856556, issued on Jul 20, 2006. The primary taxonomy on file is Hematology & Oncology Physician (207RH0003X), and the practice location is in Loris, SC. The record was last updated on Sep 2, 2025.