MEDICARE: CHANDLER CAULDER

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	225X00000X	Occupational Therapist	5941	SC
2	225X00000X	Occupational Therapist	13485	NC

General Provider Information

NPI Number	:	1891300075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANDLER CAULDER

Provider Business Mailing Address
First Line	:	2240 BLUE BONNET CIR
Second Line	:
City	:	CASTLE HAYNE
State	:	NC
Zip	:	28429-0200
Country	:	US
Telephone Number	:	843-670-4776
Fax Number	:

Provider Business Practice Location Address
First Line	:	2250 SHIPYARD BLVD STE 14
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-8070
Country	:	US
Telephone Number	:	910-518-9951
Fax Number	:	910-597-9520

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

Provider Enumeration Date	:	09/14/2020
Last Update Date	:	12/15/2025

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Directions to “ CHANDLER CAULDER ” Practice Location

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