Provider Demographics
NPI:1548397888
Name:GOLDIN, NICOLE MELISSA (DC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:MELISSA
Last Name:GOLDIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7509 NORTHSIDE DR
Mailing Address - Street 2:STE B
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-4211
Mailing Address - Country:US
Mailing Address - Phone:843-277-0707
Mailing Address - Fax:843-277-0707
Practice Address - Street 1:2 MARSHLAND RD
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-2305
Practice Address - Country:US
Practice Address - Phone:843-342-8997
Practice Address - Fax:843-342-8998
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2745111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCU91905Medicare UPIN