Organization
CAROLINA ENT, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOAN MOORE (OFFICE MANAGER)
(864) 281-9440
Entity
Organization
Contact information
Practice address
131 COMMONWEALTH DR, SUITE 230, GREENVILLE, SC 29615-4883
(864) 281-9440
Mailing address
131 COMMONWEALTH DR, SUITE 230, GREENVILLE, SC 29615-4883
(864) 281-9440
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1309
—
SC
Enumeration date
07/01/2006
Last updated
08/22/2020
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