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Organization
CAROLINA FACIAL PLASTIC SURGERY PA
Active
Organization
CAROLINA FACIAL PLASTIC SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLA CAMILLE GRAHAM MD (PRACTICE OWNER)
(843) 665-0400
Entity
Organization
Contact information
Practice address
1714 GREGG AVE, FLORENCE, SC 29501-4120
(843) 665-0400
(843) 667-8487
Mailing address
1714 GREGG AVE, FLORENCE, SC 29501-4120
(843) 665-0400
(843) 667-8487
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
16126
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP2827
—
SC
Enumeration date
07/21/2006
Last updated
01/21/2020
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