Healthcare Provider Details

I. General information

NPI: 1558348482
Provider Name (Legal Business Name): WILLIAM C. CARTER III M.D..
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 02/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 DOUGHTY ST SUITE 380
CHARLESTON SC
29403-5736
US

IV. Provider business mailing address

2687 LAKE PARK DR
N CHARLESTON SC
29406-9100
US

V. Phone/Fax

Practice location:
  • Phone: 843-577-9530
  • Fax: 843-805-6240
Mailing address:
  • Phone: 843-577-9530
  • Fax: 843-577-9531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number7869
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: