Individual provider · Type 1 NPI

Yashaswi Koguru, MD

Student in an Organized Health Care Education/Training Program · Myrtle Beach, SC

NPI number 1891543872 Active

Practice location

809 82nd Pkwy Grand Stand Medical Center
Myrtle Beach, SC 29572

Call (843) 692-1118 Map

Fax (843) 692-1122

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1891543872

Yashaswi Koguru, MD's National Provider Identifier is 1891543872, issued on May 7, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Myrtle Beach, SC. The record was last updated on Sep 20, 2024.