Individual
DR. LISA CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 E WOOD STREET, MEDICAL GROUP OF THE CAROLINAS INPATIENT MEDICINE, SPARTANBURG, SC 29303
(864) 560-6654
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304-2168
(864) 560-4123
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36185
SC
207R00000X
Internal Medicine Physician
56271
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
361852
—
SC
01
—
P01352894
RAILROAD MEDICARE
SC
Enumeration date
08/02/2006
Last updated
11/14/2014
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