Basic Information
| Provider Information | |||||||||
| NPI: | 1154880102 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORGAN | ||||||||
| FirstName: | DYLAN | ||||||||
| MiddleName: | CHASE | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | GRAND STRAND MEDICAL CENTER - GME OFFICE | ||||||||
| Address2: | 809 82ND PKWY | ||||||||
| City: | MYRTLE BEACH | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29572 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8432361950 | ||||||||
| FaxNumber: | 8432361952 | ||||||||
| Practice Location | |||||||||
| Address1: | GRAND STRAND MEDICAL CENTER - GME OFFICE | ||||||||
| Address2: | 809 82ND PKWY | ||||||||
| City: | MYRTLE BEACH | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29572 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8432361950 | ||||||||
| FaxNumber: | 8432361952 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2019 | ||||||||
| LastUpdateDate: | 08/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 82187 | SC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | LL82187 | SC | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.