Healthcare Provider Details

I. General information

NPI: 1912391533
Provider Name (Legal Business Name): CHARLES CARVER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2015
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 GILMER ST
REIDSVILLE NC
27320-3809
US

IV. Provider business mailing address

300 E WENDOVER AVE
GREENSBORO NC
27401-1229
US

V. Phone/Fax

Practice location:
  • Phone: 336-342-6196
  • Fax: 336-349-7638
Mailing address:
  • Phone: 336-663-5220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number201900450
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number201900450
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: