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NPI Code Detail

MEDICARE: CAROLINA DIGESTIVE DISEASE PA

MEDICARE: CAROLINA DIGESTIVE DISEASE PA
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
1207RG0100XGastroenterology Physician

General Provider Information

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

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Directions to “CAROLINA DIGESTIVE DISEASE PA ” Practice Location

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