Organization
CAROLINA SURGICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN W DAVIS MD (OWNER OPERATOR)
(803) 276-1866
Entity
Organization
Contact information
Practice address
2541 EVANS ST, SUITE 100, NEWBERRY, SC 29108-2963
(803) 276-1866
(803) 276-1867
Mailing address
2541 EVANS ST, SUITE 100, NEWBERRY, SC 29108-2963
(803) 276-1866
(803) 276-1867
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
28906
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194711283
NPI #
—
05
—
289066
—
SC
Enumeration date
02/22/2007
Last updated
03/03/2008
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