Healthcare Provider Details

I. General information

NPI: 1568634756
Provider Name (Legal Business Name): CAROLINA WOMEN'S HEALTH, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3404 WAKE FOREST RD SUITE 200
RALEIGH NC
27609-7340
US

IV. Provider business mailing address

3404 WAKE FOREST RD SUITE 200
RALEIGH NC
27609-7340
US

V. Phone/Fax

Practice location:
  • Phone: 919-235-0097
  • Fax: 919-235-0098
Mailing address:
  • Phone: 919-235-0097
  • Fax: 919-235-0098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35603
License Number StateNC

VIII. Authorized Official

Name: MR. JAMES STEWART CARR
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 919-235-0097