Provider Demographics
NPI:1851310783
Name:ROYAL, GAIL M (MD)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:M
Last Name:ROYAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14361 OCEAN HWY UNIT 2B
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-4806
Mailing Address - Country:US
Mailing Address - Phone:843-651-3937
Mailing Address - Fax:843-651-3940
Practice Address - Street 1:1021 CIPRIANA DR STE 220
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4621
Practice Address - Country:US
Practice Address - Phone:843-651-3937
Practice Address - Fax:843-651-3940
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16763207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC167633Medicaid
SC180020042OtherRAILROAD MEDICARE
SC180017401OtherRAILROAD MEDICARE
SCF33036Medicare UPIN
SC167633Medicaid
SCF330367622Medicare PIN
SCF330366831Medicare PIN