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Organization
CAROLINAS MEDICAL ALLIANCE INC
Active
Organization
CAROLINAS MEDICAL ALLIANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
(615) 465-7000
Entity
Organization
Contact information
Practice address
1590 FREEDOM BLVD, STE A, FLORENCE, SC 29505-6071
(843) 679-4214
Mailing address
1590 FREEDOM BLVD, STE A, FLORENCE, SC 29505-6071
(843) 679-4214
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
SC
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3747
—
SC
05
—
GP3796
—
SC
Enumeration date
05/03/2006
Last updated
08/28/2007
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