Healthcare Provider Details

I. General information

NPI: 1902803109
Provider Name (Legal Business Name): CAROLYN SHANLEY DAY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLYN SHANLEY CARTER M.D.

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 11/07/2023
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 BLUE RIDGE ROAD SUITE 300
RALEIGH NC
27607-4988
US

IV. Provider business mailing address

2800 BLUE RIDGE ROAD SUITE 300
RALEIGH NC
27607-4988
US

V. Phone/Fax

Practice location:
  • Phone: 919-784-7874
  • Fax: 919-784-2708
Mailing address:
  • Phone: 919-784-7874
  • Fax: 919-784-2708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number201301684
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number35799
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number01066148A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: