Provider Demographics
NPI:1093798969
Name:WHETSEL, CARL D (DC)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:D
Last Name:WHETSEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:BISHOPVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29010-1726
Mailing Address - Country:US
Mailing Address - Phone:803-484-9290
Mailing Address - Fax:803-484-1957
Practice Address - Street 1:134 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:BISHOPVILLE
Practice Address - State:SC
Practice Address - Zip Code:29010-1726
Practice Address - Country:US
Practice Address - Phone:803-484-9290
Practice Address - Fax:803-484-1957
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC1181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH1181Medicaid
SCT24982Medicare UPIN