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Organization
CAROLINA IMAGING CONSULTANTS P A
Active
Organization
CAROLINA IMAGING CONSULTANTS P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID DWIGHT GOLTRA JR. MD (PRESIDENT)
(843) 819-2665
Entity
Organization
Contact information
Practice address
582 LONG POINT ROAD, MT PLEASANT, SC 29464
(843) 819-2665
(843) 971-8832
Mailing address
PO BOX 100523, FLORENCE, SC 29501-0523
(843) 669-5162
(843) 667-4573
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4033
—
SC
Enumeration date
12/29/2006
Last updated
08/08/2008
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