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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
805 PAMPLICO HWY, STE B 300, FLORENCE, SC 29505-6047
(843) 676-2760
Mailing address
805 PAMPLICO HWY, STE B 300, FLORENCE, SC 29505-6047
(843) 676-2760
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3912
—
SC
Enumeration date
04/28/2006
Last updated
10/28/2011
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