Individual
PHILIP CARAVELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3361 HIGHWAY 9 E, LITTLE RIVER, SC 29566-7826
(843) 497-5929
(843) 839-4448
Mailing address
4615 OLEANDER DR, SUITE 103, MYRTLE BEACH, SC 29577-5741
(843) 497-5929
(843) 839-4448
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35040427C
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0485069
—
OH
01
—
080080657
MEDICARE RAILROAD
OH
01
—
7554
MEDICAL LICENSE
SC
Enumeration date
08/16/2006
Last updated
08/08/2012
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