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General NPI Number Information
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NPI Number | 1528233012
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Entity Type | Organization
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Legal Business Name | CAROLINA MEDICINE, P.C.
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Dates
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Enumeration Date | 04/25/2008
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 310 COURT SQUARE
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City | SANFORD
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State | NC
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Zip | 27330-5657
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Country | US
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Telephone | 919-718-5707
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Fax | 919-777-7248
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Provider Business Mailing Address
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Address Line | 310 COURT SQUARE
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City | SANFORD
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State | NC
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Zip | 27330-5657
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Country | US
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Telephone | 919-718-5707
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Fax | 919-777-7248
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | MS. ROBIN ANDREA WHITTEN
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Credential | PA-C
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Telephone | 919-718-5705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 200301154
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License Number State | NC
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