Gambacorta, Michael P

Gambacorta, Michael P is an individual health care provider with primary practice located at 100 Legends Rd Ste A, Myrtle Beach SC 29579-7076. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Gambacorta, Michael P can be contacted via phone (843) 236-9090.

Contact Information

Primary practice address
100 Legends Rd Ste A Myrtle Beach SC 29579-7076
Phone: (843) 236-9090
Fax: (843) 236-9099
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 28968 South Carolina

Profile Details

NPI number 1851393920
LBN Legal business name Gambacorta, Michael P
Credentials D.C., FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2005
Last updated Jul 10th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851393920 NPPES
Other 085UF BCBS
MEDICAID 89085UF BCBS

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