COASTAL DERMATOLOGY INSTITUTE LLC – NPI #1174122444
Dermatology

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

Health Care Provider Taxonomy Code for Dermatology

COASTAL DERMATOLOGY INSTITUTE LLC is a dermatologist located in MYRTLE BEACH, SC. NPPES has assigned the NPI number 1174122444 to COASTAL DERMATOLOGY INSTITUTE LLC on October 19, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207ND0101X from the Health Care Provider Taxonomy code set, which is classified as Dermatology, specializing in MOHS-Micrographic Surgery

The NPI profile was previously updated about 5 years ago on Jun 02, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for COASTAL DERMATOLOGY INSTITUTE LLC below.

NPI Profile for
COASTAL DERMATOLOGY INSTITUTE LLC

NPI Number
1174122444
Enumeration Date

(more than 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
COASTAL DERMATOLOGY INSTITUTE LLC
Primary location
199 VILLAGE CENTER BLVD STE 200
MYRTLE BEACH, SC 29579-3589
Phone: (843) 738-0500 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
MICHAEL CENTILLI
OWNER
Phone: (517) 203-6532
Updated
Certification Date
Jun 02, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207ND0101X
- Dermatology / MOHS-Micrographic Surgery (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.