Individual
CATHERINE ANNE GOGELA CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 936-7372
(803) 936-7102
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 936-7372
(803) 794-4317
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2013-01581
NC
207P00000X
Emergency Medicine Physician
21210
MN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2013-01581
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
37237
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558517565
—
NC
05
—
NC1910
—
SC
Enumeration date
08/09/2008
Last updated
04/20/2023
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