COASTAL CANCER CENTER LLC – NPI #1881614170
Internal Medicine

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

COASTAL CANCER CENTER LLC is a provider located in MYRTLE BEACH, SC. NPPES has assigned the NPI number 1881614170 to COASTAL CANCER CENTER LLC on July 20, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. According to the NPI Registry, there are 3 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RH0003X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Hematology & Oncology

The NPI profile was last updated on Sep 08, 2025. 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 CANCER CENTER LLC below.

NPI Profile for
COASTAL CANCER CENTER LLC

NPI Number
1881614170
Enumeration Date

(about 20 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 CANCER CENTER LLC
Primary location
8121 ROURK ST
MYRTLE BEACH, SC 29572-4128
Phone: (843) 692-5000 Fax: (843) 692-5015
3 Other location(s):
8059 Myrtle Trace Dr
Conway, SC 29526-8946
Phone: (843) 692-5000
4600 Wild Iris Dr
Myrtle Beach, SC 29577
Phone: (843) 449-9415
Fax: (843) 449-2160
4708 Oleander Dr
Myrtle Beach, SC 29577-5742
Phone: (843) 449-9415
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
VIJAY PAUDEL
PRESIDENT
Phone: (843) 692-5000
Updated
Certification Date
Sep 08, 2025

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.

Identifiers

Identifiers for COASTAL CANCER CENTER LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidNC7902484
medicaidSCPA8189
medicaidSCPG1907
medicaidSCPG1908
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.

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.