Individual
CAROL RAY YOUNG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
512 VILLAGE RD STE 101, SHALLOTTE, NC 28470-3409
(910) 721-4390
(910) 721-4399
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
(910) 721-4390
(910) 721-4399
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
0101050316
VA
207RP1001X
Pulmonary Disease Physician
32308
SC
207RP1001X
Pulmonary Disease Physician
Primary
9801123
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891220N
—
NC
01
—
GP3912
MEDICAID GROUP
SC
01
—
GP4306
MEDICAID GROUP
SC
05
—
N01124
—
SC
Enumeration date
12/23/2005
Last updated
07/20/2023
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