MEDICARE: CAROLINA BONE & JOINT PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	225100000X	Physical Therapist
2	335E00000X	Prosthetic/Orthotic Supplier	NC
3	207RR0500X	Rheumatology Physician
4	208VP0000X	Pain Medicine Physician
5	207X00000X	Orthopaedic Surgery Physician	NC

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

General Provider Information

NPI Number	:	1932189545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA BONE & JOINT PA

Provider Business Mailing Address
First Line	:	10508 PARK RD STE 120
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-8526
Country	:	US
Telephone Number	:	704-541-3055
Fax Number	:	704-319-2166

Provider Business Practice Location Address
First Line	:	1315 E SUNSET DR
Second Line	:
City	:	MONROE
State	:	NC
Zip	:	28112-4324
Country	:	US
Telephone Number	:	704-289-4595
Fax Number	:	704-289-5829

Authorized Official
Title or Position	:	PARTNER/AUTHORIZED OFFICIAL
Name	:	NEAL MICHAEL GOLDBERGER
Credential	:	MD
Telephone Number	:	704-289-4595

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	05/17/2024

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Directions to “CAROLINA BONE & JOINT PA ” Practice Location

Language	Start Address	Practice Location

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