Provider Demographics
NPI:1316408883
Name:COURTENAY, MONIQUE DORCEL (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:DORCEL
Last Name:COURTENAY
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6735 MAHI LN UNIT 4L
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-3796
Mailing Address - Country:US
Mailing Address - Phone:305-793-3127
Mailing Address - Fax:
Practice Address - Street 1:809 82ND PKWY
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4607
Practice Address - Country:US
Practice Address - Phone:843-848-4670
Practice Address - Fax:843-848-4682
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program