MEDICARE: PETER JOHN CAREK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME117968	FL
2	207QS0010X	Sports Medicine (Family Medicine) Physician	14039	SC
3	207Q00000X	Family Medicine Physician	14039	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255449294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER JOHN CAREK MD

Provider Business Mailing Address
First Line	:	300 E MCBEE AVE FL 4
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29601-2842
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	877 W FARIS RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29605-4289
Country	:	US
Telephone Number	:	864-455-7800
Fax Number	:	864-455-9082

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	02/19/2025

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Directions to “ PETER JOHN CAREK MD” Practice Location

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