Healthcare Provider Details

I. General information

NPI: 1841185865
Provider Name (Legal Business Name): CAROLINE CHANDLER DEMARCO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1268 NEXTON PKWY STE 104
SUMMERVILLE SC
29486-3169
US

IV. Provider business mailing address

306 BUNCUM DR APT 4207
MOUNT PLEASANT SC
29464-2405
US

V. Phone/Fax

Practice location:
  • Phone: 843-212-8080
  • Fax:
Mailing address:
  • Phone: 904-868-6515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: