Healthcare Provider Details

I. General information

NPI: 1518943364
Provider Name (Legal Business Name): CAROLINA MUSCULOSKELETAL INSTITUTE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 UNIVERSITY PKWY STE 2600
AIKEN SC
29801-6829
US

IV. Provider business mailing address

410 UNIVERSITY PKWY STE 2600
AIKEN SC
29801-6829
US

V. Phone/Fax

Practice location:
  • Phone: 803-644-4264
  • Fax: 803-293-1523
Mailing address:
  • Phone: 803-644-4264
  • Fax: 803-293-1523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number59
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PHILLIP T SUWAN
Title or Position: OWNER
Credential: MD
Phone: 803-644-4264