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NPI 1659648152

OrganizationActive

Coastal Podiatry, LLC

NPI 1659648152 · Podiatrist · Mount Pleasant, SC

Provider details

NPI number: 1659648152
Entity type: Organization
Primary specialty: PodiatristPodiatric Medicine & Surgery Service Providers
Authorized official: Tamika Bolden Ravenell, Owner
License: 607 (SC)

Practice location

180 Wingo Way

Suite 201

Mount Pleasant, SC 29464-1810

Phone: (916) 215-1234

Fax: (843) 606-2483

More SC providers

Mailing address

Po Box 783

Mount Pleasant, SC 29465-0783

Registry dates

Enumerated: 2011-11-28
Last updated: 2013-12-13

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Coastal Podiatry, LLC — NPI 1659648152, Mount Pleasant, SC | NPI Central