Provider Demographics
NPI:1053848952
Name:CAROLINA CARDIOVASCULAR CONSULTANTS LLC
Entity Type:Organization
Organization Name:CAROLINA CARDIOVASCULAR CONSULTANTS LLC
Other - Org Name:CAROLINA CARDIOVASCULAR CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:M
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:ALDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-669-0914
Mailing Address - Street 1:1330 HAILE ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-3002
Mailing Address - Country:US
Mailing Address - Phone:803-432-6771
Mailing Address - Fax:803-424-1900
Practice Address - Street 1:1330 HAILE ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020-3002
Practice Address - Country:US
Practice Address - Phone:803-432-6771
Practice Address - Fax:803-424-1900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC207RC0000X, 207RC0001X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty