Individual
MICHAEL B CAROTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
104 TERRAPIN CIR, SUMMERVILLE, SC 29486-8273
(843) 475-4392
Mailing address
104 TERRAPIN CIR, SUMMERVILLE, SC 29486-8273
(843) 475-4392
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1922
SC
363AM0700X
Medical Physician Assistant
MA055229
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2059PA
—
SC
Enumeration date
10/17/2011
Last updated
11/30/2022
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