Organization
CAROLINA MACULAR AND RETINAL CARE LLC
Active
Other names
Carolina Macula & Retina
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN D GROSS MD (PRESIDENT)
(843) 724-3456
Entity
Organization
Contact information
Practice address
613 LONG POINT RD, SUITE 201, MT PLEASANT, SC 29464-8350
(843) 724-3456
(843) 724-3455
Mailing address
613 LONG POINT RD, SUITE 201, MT PLEASANT, SC 29464-8350
(843) 724-3456
(843) 724-3455
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
29610
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4917
—
SC
Enumeration date
06/18/2008
Last updated
07/20/2015
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