DR. ANDREA JENNIFER CHAMCZUK (NPI# 1831475730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831475730 |
| Entity Type | Individual |
| Full Name | DR. ANDREA JENNIFER CHAMCZUK |
| Credential | MD |
| Practice Address |
920 Doug White Dr Ste 460 Myrtle Beach SC 29572-4120 |
| Practice Telephone | 8434492336 |
| Practice Fax Number | 8436922174 |
| Mailing Telephone | 8434492336 |
| Mailing Fax Number | 8436922174 |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2020-02-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 82475 | SC | Allopathic & Osteopathic Physicians |
| N | 207T00000X | Neurological Surgery | 28190 | NE | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 137129 | 05 | |
| MS | 01425552 | 05 | |
| MS | RAILROAD MEDICARE | P01212534 | 01 |
| MS | RR MCR | P01212534 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 601 N 30th St, Suite 3700, Creighton University Medical Center; Dept. of Surgery, Omaha, NE 68131 | 4027170880 | 4027176065 |
| Street Address |
920 DOUG WHITE DR STE 460 |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572-4120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487638227 | Felicia Anne E Denittis | Physician Assistant | 920 Doug White Dr Ste 460, Myrtle Beach, SC 29572-4120 | 2005-12-05 |
| 1043663750 | Kathryn Renee Mczeke | Nurse Practitioner | 920 Doug White Dr Ste 460, Myrtle Beach, SC 29572-4120 | 2016-07-18 |
| 1912315698 | Rasesh Sheth | Physician Assistant | 920 Doug White Dr Ste 460, Myrtle Beach, SC 29572-4120 | 2014-07-25 |
| 1942612684 | Lydia J. Cote | Physician Assistant | 920 Doug White Dr Ste 460, Myrtle Beach, SC 29572-4120 | 2014-05-29 |
| 1750676524 | James Haywood Smith Jr. | Neurological Surgery | 920 Doug White Dr Ste 460, Myrtle Beach, SC 29572-4182 | 2011-06-09 |
| 1114023991 | Robert J. Coni | Psychiatry & Neurology | 920 Doug White Dr Ste 460, Myrtle Beach, SC 29572-4120 | 2006-09-16 |
| 1164489829 | Mark Grinman | Psychiatry & Neurology | 920 Doug White Dr Ste 460, Myrtle Beach, SC 29572-4120 | 2006-04-27 |
| 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 | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750676524 | James Haywood Smith Jr. | Neurological Surgery | 920 Doug White Dr Ste 460, Myrtle Beach, SC 29572-4182 | 2011-06-09 |
| 1932168986 | Eugene M. Giddens | Neurological Surgery | 849 82nd Pkwy, Myrtle Beach, SC 29572-4614 | 2006-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285259374 | Brian Fabian Saway | Neurological Surgery | 96 Jonathan Lucas St Rm 301, Charleston, SC 29425-8900 | 2020-06-15 |
| 1548819170 | Carolina Neurosurgery & Spine Associates Pa | Neurological Surgery | 937 Riverwalk Pkwy Ste 101, Rock Hill, SC 29730-0179 | 2019-09-06 |
| 1487909081 | Lexington County Health Services District, Inc. | Neurological Surgery | 146 East Hospital Dr, Ste 120a, West Columbia, SC 29169 | 2012-07-19 |
| 1497016778 | Adam R Mathes | Neurological Surgery | Piedmont Spine and Neurosurgical Group, 3 St. Francis Drive, Ste 490, Greenville, SC 29601-3973 | 2012-06-04 |
| 1427358951 | The Neurological Institute of Savannah & Center for Spine P C | Neurological Surgery | 12b Arley Way Ste 103, Bluffton, SC 29910-8860 | 2010-11-01 |
| 1104142223 | Malcolm Daniel Eggart | Neurological Surgery | 4040 Highway 17 Ste 306, Murrells Inlet, SC 29576-5098 | 2010-04-14 |
| 1780917518 | Roper Saint Francis Physicians Network | Neurological Surgery | 56 Persimmons St, Suite C, Bluffton, SC 29910-7641 | 2009-09-11 |
| 1417198573 | Edward Bernard Byrd | Neurological Surgery | 2735 Royal Trace Ln, Mt Pleasant, SC 29466-8124 | 2009-03-18 |
| 1720205016 | Sharon Woods Webb | Neurological Surgery | 3 Saint Francis Dr Ste 490, Greenville, SC 29601-3973 | 2007-04-19 |
| 1841350451 | Clarendon Memorial Hospital | Neurological Surgery | 20 Hospital St, Manning, SC 29102 | 2006-12-12 |
| Find all providers with the same taxonomy | ||||
| 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.