Provider Demographics
NPI:1043971112
Name:GRAND STRAND RETINA PC
Entity type:Organization
Organization Name:GRAND STRAND RETINA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:DOERING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-651-3937
Mailing Address - Street 1:4310 HIGHWAY 17 UNIT 201
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-5139
Mailing Address - Country:US
Mailing Address - Phone:843-651-3937
Mailing Address - Fax:843-651-3940
Practice Address - Street 1:4310 HIGHWAY 17 UNIT 201
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-5139
Practice Address - Country:US
Practice Address - Phone:843-651-3937
Practice Address - Fax:843-651-3940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-31
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty