1780655316 NPI number — DR. CAROLYN L HUNTER D.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780655316 NPI number — DR. CAROLYN L HUNTER D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUNTER
Provider First Name:
CAROLYN
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
YOUNG
Provider Other First Name:
CAROLYN
Provider Other Middle Name:
LEIGH
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1780655316
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/20/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4965 CENTRE POINTE DR
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
NORTH CHARLESTON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29418-6945
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-569-2225
Provider Business Mailing Address Fax Number:
843-863-1830

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2409 MALL DR
Provider Second Line Business Practice Location Address:
STE C
Provider Business Practice Location Address City Name:
NORTH CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29406-6506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-410-7201
Provider Business Practice Location Address Fax Number:
843-863-1830
Provider Enumeration Date:
01/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2991 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: D992 . This is a "MEDICARE PTAN HEALTH EDGE" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: CH2991 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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