COASTAL GRAND OBGYN PC (NPI# 1083777486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083777486 |
| Entity Type | Organization |
| Organization Name | COASTAL GRAND OBGYN PC |
| Practice Address |
1021 Medical Cir Suite 250 Myrtle Beach SC 29572-4619 |
| Practice Telephone | 8434218200 |
| Practice Fax Number | 8438393634 |
| Mailing Telephone | 8434218200 |
| Mailing Fax Number | 8438393634 |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2008-02-13 |
| Authorized Official Name | DR. KENNETH SPIELVOGEL (OWNER/M.D.) |
| Authorized Official Telephone | 8434218200 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 222100 | SC | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP4188 | 05 |
| Street Address |
1021 MEDICAL CIR SUITE 250 |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572-4619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528031192 | Strand Physician Specialists | Pain Medicine | 1021 Medical Cir, Myrtle Beach, SC 29572-4618 | 2006-02-13 |
| 1609820588 | David R Davis | Nurse Anesthetist, Certified Registered | 1021 Medical Cir, #100, Myrtle Beach, SC 29572-4608 | 2006-05-22 |
| 1275596264 | Carolina Regional Surgery Center. Ltd | Clinic/Center | 1021 Medical Cir, Suite 100, Myrtle Beach, SC 29572-4618 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684576 | Matthew David Zeuschner | Nurse Practitioner | 107 Woodwind Court, Myrtle Beach, SC 29572 | 2020-09-16 |
| 1578191789 | Julia Ruth Nelson | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center- Gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-04-01 |
| 1407484835 | Justin Schevers | Student in an Organized Health Care Education/Training Program | 802 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-31 |
| 1922636919 | Darian Michael Quigg | Student in an Organized Health Care Education/Training Program | 809 82nd Street Parkway, Myrtle Beach, SC 29572 | 2020-03-27 |
| 1881221141 | Jonathan Alden Bryan | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-26 |
| 1215575238 | Polaris Skin Diagnostics, LLC | Dermatology | 8170 Rourk Street, Suite 100, Myrtle Beach, SC 29572 | 2019-12-20 |
| 1700348711 | Five Star Rehabilitation and Wellness Services, LLC. | Clinic/Center | 9547 N Kings Hwy, Myrtle Beach, SC 29572 | 2019-04-01 |
| 1154882975 | Michael Kouandjio | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center-gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-26 |
| 1154880102 | Dylan Chase Morgan | Internal Medicine | Grand Strand Medical Center - Gme Office, 809 82nd Pkwy, Myrtle Beach, SC 29572 | 2019-03-19 |
| 1710446828 | David Redding Kingery Jr. | Student in an Organized Health Care Education/Training Program | Gme Office 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-18 |
| Find all providers in zip 29572 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | 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. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578803672 | Felicia Squires | Specialist | 3941 Saint Ives Rd Unit 911, Myrtle Beach, SC 29588-1174 | 2013-02-26 |
| 1457603938 | David Scott Lawrence | Specialist | 514 Alder St, Suite 6, Myrtle Beach, SC 29577-3854 | 2012-10-09 |
| 1467731406 | Gamal S Boutros Md | Specialist | 605 Briarwood Dr, Suite E, Myrtle Beach, SC 29572-6734 | 2011-08-09 |
| 1205014990 | Patricia Ann Esposito | Specialist | 7719 N Kings Hwy, Myrtle Beach, SC 29572-3042 | 2008-02-05 |
| 1881884708 | Lindsey Pritchard Chappell | Specialist | 121 Gateway Rd., Suite B, Myrtle Beach, SC 29526 | 2007-07-26 |
| 1619904752 | Deborah Cook | Specialist | 3675 Spruce Dr, Myrtle Beach, SC 29577-5005 | 2006-06-26 |
| 1649245358 | John M Davis | Specialist | 849 82nd Pkwy, Myrtle Beach, SC 29572-4614 | 2006-02-17 |
| 1952385288 | Coastal Cardiovascular Surgery, LLC | Specialist | 933 Medical Cir, Myrtle Beach, SC 29572-4116 | 2005-11-30 |
| 1740276971 | Amy L King | Specialist | 4378 Oleander Dr, Myrtle Beach, SC 29577 | 2005-09-22 |
| 1760478242 | Russell Frank Stahl | Specialist | 920 Doug White Dr Ste 510, Myrtle Beach, SC 29572-4120 | 2005-09-21 |
| Find all providers in MYRTLE BEACH | ||||
| City | MYRTLE BEACH |
| Zip Code | 29572 |
Please comment or provide details below to improve the information on COASTAL GRAND OBGYN PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.