# SHOCKWAVE SPECIALISTS OF THE CAROLINAS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063446961
- **Authorized official:** MR. M FILMORE HODNETT MBA CPA (BUSINESS MANAGER)
- **Authorized official phone:** (704) 897-2031

## Contact information

- **Practice address:** 705 GRIFFITH ST, STE 205, DAVIDSON, NC 28036
- **Practice address phone:** (704) 897-1024
- **Practice address fax:** (704) 897-2033
- **Mailing address:** PO BOX 30428, CHARLOTTE, NC 28230
- **Mailing address phone:** (704) 897-1024
- **Mailing address fax:** (704) 897-2033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 00000 | NC | Yes |

## Other

- **Enumeration date:** 07/10/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 014GA | BCBS | NC |