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COASTAL CAROLINA NEPHROLOGY LLC NPI 1679554752


NPI Information

NPI: 1679554752
Provider Name: COASTAL CAROLINA NEPHROLOGY LLC

Former Legal Business Name: TRIDENT NEPHROLOGY LLC

Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
1938-A CHARLIE HALL BLVD
CHARLESTON, SC
ZIP 29414
Phone: (843) 554-9313
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COASTAL CAROLINA NEPHROLOGY LLC is a nephrology internal medicine in Charleston, SC. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. COASTAL CAROLINA NEPHROLOGY LLC NPI is 1679554752. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Trident Nephrology Llc.

The provider's business location address is:

1938-A CHARLIE HALL BLVD
CHARLESTON, SC
ZIP 29414-837
Phone: (843) 554-9313
Fax: (843) 744-5961

The provider's authorized official is Lisa R Stewart .
The authorized official title is Partner and has the following contact phone number (843) 554-9313.

The enumeration date for this NPI number is 11/7/2005 and was last updated on 8/29/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RN0300XInternal MedicineNephrologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18172OTHERMEDICARE GROUP
2GP2967OTHERMEDICAID GROUP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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