Provider Demographics
NPI:1225084684
Name:COASTAL WOMENS CARE
Entity Type:Organization
Organization Name:COASTAL WOMENS CARE
Other - Org Name:CHRISTINE CASE MD
Other - Org Type:Other Name
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CASE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-572-5001
Mailing Address - Street 1:9221 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:N CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406
Mailing Address - Country:US
Mailing Address - Phone:843-572-5001
Mailing Address - Fax:843-572-9636
Practice Address - Street 1:9221 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 2E
Practice Address - City:N CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406
Practice Address - Country:US
Practice Address - Phone:843-572-5001
Practice Address - Fax:843-572-9636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11389207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP0472Medicaid
SCGP0472Medicaid
SC3903Medicare PIN