Individual
CAROL J SOUCIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6555 KEE LN STE 200, HARRISBURG, NC 28075-7463
(704) 316-6140
(704) 316-6141
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36600
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160721
WELLPATH
NC
01
—
18356
PARTNERS MEDICARE CHOICE
NC
01
—
344285
MAMSI
NC
01
—
36213
MEDCOST
NC
01
—
4293938
AETNA
NC
01
—
566000156
PRACTICE TAX ID
NC
01
—
78447
BCBS
NC
05
—
8978447
—
NC
Enumeration date
02/03/2006
Last updated
10/25/2020
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