NPI 1548459597

Coastal Family Medicine

Organisation Legal Medicine Conway, SC

Practice location

Address: 8014 Myrtle Trace Dr, Conway, SC 29526-8945
Phone: (843) 347-7224
Fax: (843) 347-7335

Authorised official

Name: Jonathan L Dieter
Title: Owner
Phone: (843) 347-7224

Registered specialties

Legal Medicine Primary

Other Service Providers Taxonomy 173000000X Licence MD 7055 (SC)

Other Legal Medicine providers in South Carolina →

Registry record

NPI: 1548459597
Entity type: Organization
NPI issued: 16 Oct 2007
Record last updated: 17 Oct 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.