| Organization Name: | CAROLINA COASTAL PLASTIC AND RECONSTRUCTIVE SURGERY, INC. |
| NPI Number: | 1003096058 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEVEN K WHITE (CEO/OWNER) |
| Mailing Address: | 1275 21st Ave N Build #1 Myrtle Beach |
| State: | SC US |
| Postal Code: | 295777429 |
| Phone Number: | 8434489977 |
| Fax Number: | 8436267755 |
| NPI Enumeration Date: | 11/07/2007 |
| NPI Last Update Date: | 06/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0122X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Plastic and Reconstructive Surgery |
| Taxonomy Definition: | A surgeon who specializes in plastic and reconstructive surgery. |