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SEASIDE DERMATOLOGY PA
NPI 1376969428
Dermatology in Murrells Inlet, SC

Active since March 13, 2014
4017 HIGHWAY 17, SUITE 200, MURRELLS INLET, SC 29576(843) 651-4600(843) 651-4601 Get Directions Write a Review

NPPES record last updated: March 4, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Seaside Dermatology Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SEASIDE DERMATOLOGY PA (NPI 1376969428) is a healthcare organization registered as a dermatology in Murrells Inlet, South Carolina and active in the NPI registry since March 2014. The organization lists Vienna L. Gibson, Owner, as its authorized official.

NPPES Registry Identity

NPI1376969428
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSEASIDE DERMATOLOGY PA
Location Address4017 HIGHWAY 17, SUITE 200Murrells Inlet, SC 29576-5032
Mailing AddressPo Box 691Murrels Inlet, SC 29576 · (843) 651-4600
Phone(843) 651-4600
Fax(843) 651-4601
Organization SubpartNo
Authorized OfficialVienna L. GibsonOwner · (843) 651-4600
Enumeration DateMarch 13, 2014
Last NPPES UpdateMarch 4, 2020
NPPES CertifiedMarch 4, 2020
✔ NPI 1376969428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in SC · 36498
Definition
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.
4017 HIGHWAY 17, Murrells Inlet, SC 29576
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 42D2079058

Seaside Dermatology, PA · Murrells Inlet, SC
Expired · Jul 31, 2026
CLIA Number42D2079058
Laboratory TypePhysician Office
Certificate Effective DateMarch 1, 2024
Certificate Expiration DateJuly 31, 2026
Laboratory DirectorDr. Vienna L. Gibson
Laboratory Phone(843) 651-4600
Laboratory LocationSeaside Dermatology, PA4017 Hwy 17, Suite 200, Murrells Inlet, SC 29576
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEFFREY ANTIOHO MSW
Social Worker (Clinical)
4017 HIGHWAY 17
MURRELLS INLET, SC 29576
Georgetown County (843) 685-9228
BETH CHARLETTE CNM
Midwife
4017 HIGHWAY 17
MURRELLS INLET, SC 29576
Georgetown County (843) 651-6525
CYTO LAB INC.
Pathology (Anatomic Pathology)
4017 HIGHWAY 17, SUITE 203
MURRELLS INLET, SC 29576
Georgetown County (843) 652-4522
RACHEL HOLLEY PAULL PA
Physician Assistant (Medical)
4017 HIGHWAY 17, SUITE 200
MURRELLS INLET, SC 29576
Georgetown County (843) 651-4600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Seaside Dermatology PA's NPI number?

The NPI number for Seaside Dermatology PA is 1376969428. It was assigned to this organization in the NPPES registry on March 13, 2014.

Where is Seaside Dermatology PA located?

Seaside Dermatology PA is located at 4017 Highway 17 Suite 200, Murrells Inlet, SC 29576. The listed phone number is (843) 651-4600.

What is Seaside Dermatology PA's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

What insurance does Seaside Dermatology PA accept?

Health plans from BlueCross BlueShield of South Carolina list Seaside Dermatology PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Seaside Dermatology PA was last updated on March 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.