Provider Demographics
NPI:1073250445
Name:CAROLINA VASCULAR CARE PLLC
Entity Type:Organization
Organization Name:CAROLINA VASCULAR CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-220-5470
Mailing Address - Street 1:45 GUARDIAN CT STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-3019
Mailing Address - Country:US
Mailing Address - Phone:252-220-5470
Mailing Address - Fax:252-627-9091
Practice Address - Street 1:45 GUARDIAN CT STE 100
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3019
Practice Address - Country:US
Practice Address - Phone:252-220-5470
Practice Address - Fax:252-627-9091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty