Organization
ORTHOCAROLINA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT SHEAR (CFO)
(704) 323-2222
Entity
Organization
Contact information
Practice address
1007 CHERAW ST, BENNETTSVILLE, SC 29512-2422
(843) 479-8357
(910) 277-4244
Mailing address
PO BOX 117444, ATLANTA, GA 30368-7444
(704) 323-2000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
38865
NC
225100000X
Physical Therapist
38865
NC
363A00000X
Physician Assistant
38865
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E08569
—
SC
Enumeration date
09/14/2010
Last updated
10/25/2024
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