Seaside Dermatology PA
NPI 1376969428ActiveOrganization· Dermatology· Murrells Inlet, SC
Dermatology in Murrells Inlet, South Carolina, registered in NPPES in March 2014. The authorized official on file is Vienna L. Gibson, DO, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1376969428 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 13, 2014 |
| Last updated in NPPES | Mar 4, 2020 |
| Certified by provider | Mar 4, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | 36498 | SC |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (SC) |
|---|
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