Doctor Name: | DR. CHRYSTAL MARIE COATES |
NPI Number: | 1972941649 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | |
Business Practice Address: | 4999 Carolina Forest Blvd Suite 9 Myrtle Beach, SC - 295793587 |
Business Phone Number: | 8432362700 |
Business Fax Number: | 8432362726 |
Mailing Address: | Po Box 6407, FLORENCE |
State: | SC |
Postal Code: | 295026407 |
Phone Number: | 8436695162 |
Fax Number: | 8436674573 |
NPI Enumeration Date: | 06/04/2013 |
NPI Last Update Date: | 08/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |