Healthcare Provider Details
I. General information
NPI: 1134454853
Provider Name (Legal Business Name): CAROLINA PAIN ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/14/2009
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
330 BILLINGSLEY RD STE 206
CHARLOTTE NC
28211-5020
US
IV. Provider business mailing address
PO BOX 1844
BRYSON CITY NC
28713-1844
US
V. Phone/Fax
- Phone: 704-347-3447
- Fax: 704-347-3440
- Phone: 704-347-3447
- Fax: 704-347-3440
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GERALD
MARTIN
ARONOFF
Title or Position: PRESIDENT
Credential: MD
Phone: 704-347-3447