Provider Demographics
NPI:1083667570
Name:CAROLINA INTERNAL MEDICINE OF UNION, LLC
Entity Type:Organization
Organization Name:CAROLINA INTERNAL MEDICINE OF UNION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:STOCKINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-427-9311
Mailing Address - Street 1:1005 THOMPSON BLVD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379-7409
Mailing Address - Country:US
Mailing Address - Phone:864-427-9311
Mailing Address - Fax:864-427-9309
Practice Address - Street 1:1005 THOMPSON BLVD
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-7409
Practice Address - Country:US
Practice Address - Phone:864-427-9311
Practice Address - Fax:864-427-9309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP1330Medicaid
SCGP1330Medicaid