=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144657891
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOHN E CAREY MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2013
-----------------------------------------------------
Last Update Date | 09/26/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8 MEMORIAL MEDICAL CT ST 4
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29605-4449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-269-9899
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8 MEMORIAL MEDICAL CT ST 4
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29605-4449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JOHN E CAREY
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 864-269-9899
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 14572
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------