Healthcare Provider Details

I. General information

NPI: 1568874691
Provider Name (Legal Business Name): STEPHEN MICHAEL CAREK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2014
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

877 W FARIS RD STE A
GREENVILLE SC
29605
US

IV. Provider business mailing address

5005 SW 88TH TER
GAINESVILLE FL
32608-4179
US

V. Phone/Fax

Practice location:
  • Phone: 864-455-7800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number200814
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number52297
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number52297
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: