NPIMap

Organization Active NPI

Seacoast ENT & Facial Plastic Surgery, PA

  • Facial Plastic Surgery Physician
  • Little River, SC
National Provider Identifier
1386698165
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
28577 Issued in SC
Legal business name
SEACOAST ENT & FACIAL PLASTIC SURGERY, PA
Practice address
4000 Highway 9 E
Suite 270
Little River, SC 29566-7833
Phone
(843) 390-4200
NPI assigned
May 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Michael David Peters, M.D.NPI 1194775429
Title
President
Phone
(843) 390-4200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X 28577 SC Primary

Addresses

Primary practice location

4000 Highway 9 E
Suite 270
Little River, SC 29566-7833

Mailing address

4000 Highway 9 E
Suite 270
Little River, SC 29566-7833
Phone (843) 390-4200

National Provider Directory

National Provider Directory

Locations

4000 Highway 9 E
Ste 270
Little River, SC 29566
Phone (843) 390-4200

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386698165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 HIGHWAY 9 E",
            "address_2": "SUITE 270",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295667833",
            "telephone_number": "843-390-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 HIGHWAY 9 E",
            "address_2": "SUITE 270",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295667833",
            "telephone_number": "843-390-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEACOAST ENT & FACIAL PLASTIC SURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-390-4200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "SC",
            "license": "28577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little River, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.