DR. MICHAEL COLETTA (NPI# 1073059911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073059911 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL COLETTA |
| Credential | M.D. |
| Practice Address |
809 82nd Pkwy Myrtle Beach SC 29572 |
| Mailing Address |
809 82nd Pkwy Myrtle Beach SC 29572-4607 |
| Practice Telephone | 8436921000 |
| Mailing Telephone | 8436921000 |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2019-07-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 82076 | SC | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Cooper Plz, Camden, NJ 081031461 | 8563422000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588920656 | Michael Anthony Coletta | Pharmacist | 1309 N High St, Fort Atkinson, WI 53538-1255 | 2012-04-03 |
| Street Address |
809 82ND PKWY |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679577035 | Thomas J Martel | Emergency Medicine | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2005-06-13 |
| 1104455211 | Chad Byrd | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-04-02 |
| 1831727122 | Michael Ladd | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-31 |
| 1932737335 | Aditya Ragunathan | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-31 |
| 1710515242 | Elise Erin Steinberger | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-30 |
| 1962030866 | Mitsy Jannet Moreno | Internal Medicine | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-28 |
| 1659908648 | Emma Kaitlyn Rousakis | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-27 |
| 1992333819 | Paul Harwood Hargrave | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-27 |
| 1134756109 | Oyindamola Awe | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-26 |
| 1003443292 | Benjamin Tyler Mckinney | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684576 | Matthew David Zeuschner | Nurse Practitioner | 107 Woodwind Court, Myrtle Beach, SC 29572 | 2020-09-16 |
| 1578191789 | Julia Ruth Nelson | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center- Gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-04-01 |
| 1407484835 | Justin Schevers | Student in an Organized Health Care Education/Training Program | 802 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-31 |
| 1922636919 | Darian Michael Quigg | Student in an Organized Health Care Education/Training Program | 809 82nd Street Parkway, Myrtle Beach, SC 29572 | 2020-03-27 |
| 1881221141 | Jonathan Alden Bryan | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-26 |
| 1215575238 | Polaris Skin Diagnostics, LLC | Dermatology | 8170 Rourk Street, Suite 100, Myrtle Beach, SC 29572 | 2019-12-20 |
| 1700348711 | Five Star Rehabilitation and Wellness Services, LLC. | Clinic/Center | 9547 N Kings Hwy, Myrtle Beach, SC 29572 | 2019-04-01 |
| 1154882975 | Michael Kouandjio | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center-gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-26 |
| 1154880102 | Dylan Chase Morgan | Internal Medicine | Grand Strand Medical Center - Gme Office, 809 82nd Pkwy, Myrtle Beach, SC 29572 | 2019-03-19 |
| 1710446828 | David Redding Kingery Jr. | Student in an Organized Health Care Education/Training Program | Gme Office 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-18 |
| Find all providers in zip 29572 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295184208 | Doctors Care, Pa | Emergency Medicine | 2761 Agnes Ln, Myrtle Beach, SC 29577-2029 | 2016-06-09 |
| 1235424136 | Jiajia O'shea | Emergency Medicine | 55 Bayberry Ln, Myrtle Beach, SC 29572-5600 | 2011-06-20 |
| 1942464946 | Shanmukesh Lingamaneni | Emergency Medicine | 481 Harbour View Dr, Myrtle Beach, SC 29579-7449 | 2008-07-18 |
| 1538286208 | David C Sasser | Emergency Medicine | 249 Venice Way Unit 3103, Myrtle Beach, SC 29577-6304 | 2007-03-26 |
| 1134238371 | Daniel M Mcnabb | Emergency Medicine | Carolina Health Specialists 4615 Oleander Dr, Suite 201-a, Myrtle Beach, SC 29577-1622 | 2006-08-30 |
| 1154350965 | Dalal A Akoury | Emergency Medicine | 4710 Oleander Drive, Myrtle Beach, SC 29577-5898 | 2006-07-02 |
| 1568464469 | Janice L Hart | Emergency Medicine | 9820 N Kings Hwy, Myrtle Beach, SC 29572-4013 | 2005-08-11 |
| 1679577035 | Thomas J Martel | Emergency Medicine | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2005-06-13 |
| 1659875003 | Denver Rogalla | Emergency Medicine | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2018-03-21 |
| 1942731500 | Jacob Daniel Pope | Emergency Medicine | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2017-03-24 |
| Find all providers in MYRTLE BEACH | ||||
| City | MYRTLE BEACH |
| Zip Code | 29572 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.