Provider Demographics
NPI:1063465250
Name:COASTAL PULMONARY, LLP
Entity Type:Organization
Organization Name:COASTAL PULMONARY, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-722-1209
Mailing Address - Street 1:63 GADSDEN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-1211
Mailing Address - Country:US
Mailing Address - Phone:843-722-1209
Mailing Address - Fax:
Practice Address - Street 1:63 GADSDEN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1211
Practice Address - Country:US
Practice Address - Phone:843-722-1209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty