Christopher Acquaviva, DO
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Myrtle Beach, SC
NPI 1831991629 · NPPES record last updated Mar 25, 2025
Key facts
- NPI
- 1831991629
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- Tidelands Health Family Medicine
4320 Holmestown Road
Myrtle Beach, SC 29588 - Phone
- (843) 652-8440
- NPI assigned
- Mar 25, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Osteopathy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
Tidelands Health Family Medicine
4320 Holmestown Road
Myrtle Beach, SC 29588
Mailing address
Tidelands Health Family Medicine
4320 Holmestown Road
Myrtle Beach, SC 29588
Phone (843) 652-8440
Other providers in Myrtle Beach, SC
- Nancy Abrahams
- David E Abramovitz
- Ibrahim Mohammad Abu Dayah
- Lauren Sattele Abusal
- Accuquest Hearing Center, LLC
- Acs Primary Care Physicians - Southeast PC
- Active SC One, Inc.
- Alec Alexander Adams
- Amber Lee Adams
- Ashley Adams
All providers in Myrtle Beach, SC · Student in an Organized Health Care Education/Training Program in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.