WACCAMAW DERMATOLOGY AND PLASTIC SURGERY (NPI# 1437308814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437308814 |
| Entity Type | Organization |
| Organization Name | WACCAMAW DERMATOLOGY AND PLASTIC SURGERY |
| Practice Address |
917 Medical Circle Myrtle Beach SC 29572-4116 |
| Practice Telephone | 8434490453 |
| Practice Fax Number | 8434974822 |
| Mailing Telephone | 8434490453 |
| Mailing Fax Number | 8434974822 |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2008-09-25 |
| Authorized Official Name | DR. THOMAS E QUIRKE (PRESIDENT) |
| Authorized Official Telephone | 8434490453 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP1554 | 05 |
| Street Address |
917 MEDICAL CIRCLE |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572-4116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962449181 | Waccamaw Dermatology, LLC | Dermatology | 917 Medical Circle, Myrtle Beach, SC 29572 | 2006-05-31 |
| 1093759755 | Joan M Wiss | Dermatology | 917 Medical Circle, Myrtle Beach, SC 29572 | 2006-06-15 |
| 1144267261 | Robert D Bibb | Dermatology | 917 Medical Circle, Myrtle Beach, SC 29572 | 2006-05-31 |
| 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 | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982641106 | Carl Edward Weimer Jr. | Dermatology | 1240 21st Avenue N, Suite 106, Myrtle Beach, SC 29577-7431 | 2006-05-31 |
| 1962449181 | Waccamaw Dermatology, LLC | Dermatology | 917 Medical Circle, Myrtle Beach, SC 29572 | 2006-05-31 |
| 1033160213 | Grand Strand Dermatology | Dermatology | 3001 Newcastle Loop, Myrtle Beach, SC 29588-4502 | 2006-05-13 |
| 1306819990 | Daniel B Ward Jr. | Dermatology | 8208 Devon Ct, Suite B, Myrtle Beach, SC 29572-4178 | 2006-02-13 |
| 1497759278 | Luther Rawls Williams Jr. | Dermatology | 4573 Oleander Dr, Myrtle Beach, SC 29577-5755 | 2005-06-09 |
| 1245627439 | Michael Xiong | Dermatology | 917 Medical Cir, Myrtle Beach, SC 29572-4116 | 2015-04-25 |
| 1073946315 | Dermatology and Skin Cancer Center of South Carolina PC | Dermatology | 5046 Highway 17 Byp S, Suite 103, Myrtle Beach, SC 29588-4503 | 2013-08-09 |
| 1215223326 | Michael Robert Centilli | Dermatology | 5046 Highway 17 Byp S Ste 103, Myrtle Beach, SC 29588-4503 | 2011-06-27 |
| 1720309941 | Mary Hollingsworth Bowdre Glover | Dermatology | 3001 Newcastle Loop, Myrtle Beach, SC 29588-4502 | 2010-06-22 |
| 1306072566 | Weimer Skin Clinic, P.a. | Dermatology | 1240 21st Avenue N, Suite 106, Myrtle Beach, SC 29577-7431 | 2009-06-02 |
| Find all providers in MYRTLE BEACH | ||||
| City | MYRTLE BEACH |
| Zip Code | 29572 |
Please comment or provide details below to improve the information on WACCAMAW DERMATOLOGY AND PLASTIC SURGERY.
| 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.