Provider Demographics
NPI:1316408883
Name:COURTENAY, MONIQUE DORCEL (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:DORCEL
Last Name:COURTENAY
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6735 MAHI LN UNIT 4L
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-3796
Mailing Address - Country:US
Mailing Address - Phone:305-793-3127
Mailing Address - Fax:
Practice Address - Street 1:2728 SUNSET BLVD STE 106
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4836
Practice Address - Country:US
Practice Address - Phone:803-314-9760
Practice Address - Fax:803-314-9761
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC90067207W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology