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General NPI Number Information
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NPI Number | 1285929794
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Entity Type | Organization
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Legal Business Name | CAROLINA DIGESTIVE DISEASE PA
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 2750 LAUREL ST STE 201
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City | COLUMBIA
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State | SC
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Zip | 29204-2024
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Country | US
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Telephone | 803-799-8098
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Fax | 803-255-0018
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Provider Business Mailing Address
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Address Line | 950 E STATE HIGHWAY 114 STE 200
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City | SOUTHLAKE
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State | TX
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Zip | 76092-5261
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Country | US
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Telephone | 214-424-2200
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Fax | 214-231-2159
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Authorized Official
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Title or Position | CEO
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Name | JAMES J WEBER
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Credential |
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Telephone | 214-424-2213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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