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General NPI Number Information
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NPI Number | 1699768986
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Entity Type | Organization
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Legal Business Name | CAROLINA MEDICAL CENTER
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 12/28/2009
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Provider Practice Location Address
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Address Line | 2 ROPER CORNERS CIR
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City | GREENVILLE
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State | SC
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Zip | 29615-4833
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Country | US
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Telephone | 864-281-9999
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Fax | 864-281-9990
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Provider Business Mailing Address
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Address Line | 2 ROPER CORNERS CIR
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City | GREENVILLE
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State | SC
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Zip | 29615-4833
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Country | US
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Telephone | 864-281-9999
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Fax | 864-281-9990
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DIANE DYER
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Credential |
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Telephone | 864-281-9999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0342
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License Number State | SC
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