Organization
CAROLINA SPECIALTY CARE,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT I WODECKI MD (VICE -PRESIDENT)
(704) 872-8711
Entity
Organization
Contact information
Practice address
124 SUNSET HILL DR, STATESVILLE, NC 28625-2729
(704) 872-8711
(704) 872-5866
Mailing address
124 SUNSET HILL RD, STATESVILLE, NC 28625
(704) 872-8711
(704) 872-5866
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
930036
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89014TM
—
NC
05
—
89016CP
—
NC
Enumeration date
01/30/2007
Last updated
07/16/2009
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