MARISTELA Y NABONG-NILLAS (NPI# 1629155338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629155338 |
| Entity Type | Individual |
| Full Name | MARISTELA Y NABONG-NILLAS |
| Credential | M.D. |
| Practice Address |
4220 Carolina Exchange Dr Myrtle Beach SC 29579-4220 |
| Mailing Address |
Po Box 547 Little River SC 29566-0547 |
| Practice Telephone | 8436638000 |
| Practice Fax Number | 8436638123 |
| Mailing Telephone | 8436638000 |
| Mailing Fax Number | 8436638123 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2019-11-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 30745 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 307457 | 05 | |
| NJ | 6961002 | 05 |
| Street Address |
4220 CAROLINA EXCHANGE DR |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29579-4220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922055722 | Romeo Torres Nillas | Internal Medicine | 4220 Carolina Exchange Dr, Myrtle Beach, SC 29579-4220 | 2006-05-27 |
| 1730552837 | Janice Moore | Nurse Practitioner | 4220 Carolina Exchange Dr, Myrtle Beach, SC 29579-4220 | 2015-11-11 |
| 1770982472 | Virginia Hornbeck | Counselor | 4220 Carolina Exchange Dr, Myrtle Beach, SC 29579-4220 | 2014-08-19 |
| 1356740351 | Tricia Payne | Social Worker | 4220 Carolina Exchange Dr, Myrtle Beach, SC 29579-4220 | 2014-08-15 |
| 1487931341 | Little River Medical Center Pharmacy | Pharmacy | 4220 Carolina Exchange Dr, Myrtle Beach, SC 29579-4220 | 2011-11-07 |
| 1043508708 | Eunice Luz Guzman | Internal Medicine | 4220 Carolina Exchange Dr, Myrtle Beach, SC 29579-4220 | 2011-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598323198 | P & E Company | Counselor | 4105 Carolina Commercial Dr. Unit #2, Myrtle Beach, SC 29579 | 2019-05-30 |
| 1528624632 | Matthew Meehan | Nurse Practitioner | 4016 River Oaks Dr # 6511, Myrtle Beach, SC 29579 | 2019-05-14 |
| 1427518265 | Brian Donovan Doherty | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center 809 82nd Parkway, Gme Office, Myrtle Beach, SC 29579 | 2019-03-20 |
| 1508347931 | South Carolina Cvs Pharmacy LLC | Pharmacy | 578 International Dr, Myrtle Beach, SC 29579 | 2018-08-23 |
| 1497256176 | Orthosc LLC | Orthopaedic Surgery | 185 Fresh Dr Ste B, Myrtle Beach, SC 29579 | 2018-02-27 |
| 1740708981 | Dental Professional of South Carolina, P.C. | Dentist | 568 International Dr, Myrtle Beach, SC 29579 | 2017-09-08 |
| 1093232480 | Johnathan T Steppe | Dentist | 568 International Drive, Myrtle Beach, SC 29579 | 2017-08-25 |
| 1346638483 | Little River Medical Center, Inc | Clinic/Center | 4220 Carolina Exchange Blvd, Myrtle Beach, SC 29579 | 2014-12-23 |
| 1154726818 | Mina Gaid | Pharmacist | 1303 38th Avenue North, Myrtle Beach, SC 29579 | 2014-10-23 |
| 1528471364 | Paola Goyeneche | Counselor | 5015 Carolina Forest Blvd, Myrtle Beach, SC 29579 | 2014-06-10 |
| Find all providers in zip 29579 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053967943 | Georgetown Physician Associates, LLC | Pediatrics | 4320 Holmestown Rd Ste B, Myrtle Beach, SC 29588-7837 | 2019-08-15 |
| 1801328471 | Alyse Elkins | Pediatrics | 8120 Rourk Street, Myrtle Beach, SC 29572 | 2017-04-01 |
| 1407174147 | Kristina Nicole Carswell | Pediatrics | 406 46th Ave N, Myrtle Beach, SC 29577-2732 | 2010-05-05 |
| 1790905867 | Corinne M Adkins | Pediatrics | Grand Stand Pediatrics, 8120 Rourk Street, Myrtle Beach, SC 29572 | 2007-04-30 |
| 1801931910 | Ocean Sands Pediatrics | Pediatrics | 4728 Jenn Dr, Suite 103, Myrtle Beach, SC 29577-5714 | 2007-02-20 |
| 1346213485 | Erin E.w. Smith | Pediatrics | 8120 Rourk St, Myrtle Beach, SC 29572 | 2006-02-09 |
| 1659373108 | William E Nichols | Pediatrics | 4022 Postal Way Ste C, Myrtle Beach, SC 29579-3537 | 2005-08-15 |
| 1184623530 | Rebecca S Eglen | Pediatrics | 6010 Highway 707, Ste 100, Myrtle Beach, SC 29588-7321 | 2005-07-19 |
| 1699156364 | Megan Thompson Hall | Pediatrics | 5010 Carolina Forest Blvd, Myrtle Beach, SC 29579-3579 | 2015-06-17 |
| 1316342504 | Sheridan Children's Healthcare Services of South Carolina, Pa | Pediatrics | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2014-10-30 |
| Find all providers in MYRTLE BEACH | ||||
| City | MYRTLE BEACH |
| Zip Code | 29579 |
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| 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.