Healthcare Provider Details

I. General information

NPI: 1689778300
Provider Name (Legal Business Name): CAROLINA HAND AND SPORTS MEDICINE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 MEDICAL PARK DRIVE
ASHEVILLE NC
28803
US

IV. Provider business mailing address

18 MEDICAL PARK DRIVE
ASHEVILLE NC
28803-2493
US

V. Phone/Fax

Practice location:
  • Phone: 828-253-7521
  • Fax: 828-251-5992
Mailing address:
  • Phone: 828-253-7521
  • Fax: 828-251-5992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SHELLEY COOLEY
Title or Position: OPERATIONS SUPERVISOR
Credential:
Phone: 828-253-7521