Provider Demographics
NPI:1215031653
Name:CAROLINA RHEUMATOLOGY & NEUROLOGY ASSOC.
Entity Type:Organization
Organization Name:CAROLINA RHEUMATOLOGY & NEUROLOGY ASSOC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FINK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-692-0968
Mailing Address - Street 1:8220 NIGELS DRIVE
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4125
Mailing Address - Country:US
Mailing Address - Phone:843-692-0968
Mailing Address - Fax:843-692-2688
Practice Address - Street 1:8220 NIGELS DRIVE
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4125
Practice Address - Country:US
Practice Address - Phone:843-692-0968
Practice Address - Fax:843-692-2688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC6954Medicare PIN