| Coastal Podiatry Llc | |
|
180 Wingo Way, Suite 201, Mount Pleasant, SC 29464-1810 | |
| (843) 856-5337 | |
| (843) 606-2483 |
| Full Name | Coastal Podiatry Llc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 180 Wingo Way, Mount Pleasant, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588965586 | NPI | - | NPPES |
| GP9889 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | POD 607 (South Carolina) | Primary |
| Provider Name | Tamika Michelle Bolden Ravenell |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1598924581 PECOS PAC ID: 4880710086 Enrollment ID: I20100924000919 |
| Provider Name | Rahn A Ravenell |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1639492473 PECOS PAC ID: 8022204411 Enrollment ID: I20101124000604 |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Podiatry Llc Po Box 783, Mount Pleasant, SC 29465-0783 Ph: (916) 215-1234 | Coastal Podiatry Llc 180 Wingo Way, Suite 201, Mount Pleasant, SC 29464-1810 Ph: (843) 856-5337 |
East Cooper Podiatry, P.a. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 389 Johnnie Dodds Blvd, Suite 100, Mount Pleasant, SC 29464 Phone: 843-881-3668 Fax: 843-881-9191 | |
Associated Foot Specialists, Pa Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 180 Wingo Way, Suite 101, Mount Pleasant, SC 29464 Phone: 843-856-5337 | |
Gregory Santamaria, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1112 Johnnie Dodds Blvd, Mount Pleasant, SC 29464 Phone: 843-981-5008 Fax: 843-981-5016 | |
Vishal Sanjay Desai, Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 501 Bramson Ct Unit 301, Mount Pleasant, SC 29464 Phone: 843-654-8250 | |
Dr. Tamika M Bolden Ravenell, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 180 Wingo Way, Suite 201, Mount Pleasant, SC 29464 Phone: 843-856-5337 | |
Coastal Podiatry, Llc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 180 Wingo Way, Suite 201, Mount Pleasant, SC 29464 Phone: 916-215-1234 Fax: 843-606-2483 |