Organization · Type 2 NPI

Grand Strand Plastic & Reconstructive Surgery Center PA

Specialist · Myrtle Beach, SC

NPI number 1619157294 Active

Practice location

4610 Oleander Dr, Suite 101
Myrtle Beach, SC 29577-5752

Fax (843) 449-9265

Specialties and licenses

Taxonomy	Code	License
Specialist Primary	174400000X	15346 (SC)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

4 other providers at this address

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NPI record

NPI: 1619157294
Entity type: Organization (Type 2)
Issued: Nov 12, 2007
Last updated: Mar 2, 2025
Status: Active
Subpart: Yes of Grand Strand Plastic and Reconstructive Surgery Center, P.a.

Other names

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Grand Strand Plastic Surgery · doing business as
Grand Strand Plastic and Reconstructive Surgery Center, P.a. · doing business as

Authorized official

Dr. Kimberley B Goh, MD
President
(843) 497-2227

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1619157294

Grand Strand Plastic & Reconstructive Surgery Center PA's National Provider Identifier is 1619157294, issued on Nov 12, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Myrtle Beach, SC. The record was last updated on Mar 2, 2025.