Provider Demographics
NPI:1275586471
Name:CARSTEN, CHRISTOPHER G III (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:G
Last Name:CARSTEN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:200 PATEWOOD DR
Practice Address - Street 2:SUITE C300
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3593
Practice Address - Country:US
Practice Address - Phone:864-454-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC166142086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC20051570OtherRR MEDICARE
SC166144Medicaid
SC20051570OtherRR MEDICARE
SCG88900Medicare UPIN
SC7982161OtherAETNA
SCG88900Medicare UPIN
SC7629128OtherCIGNA
SCG889007951Medicare PIN
SC57-6007863073OtherBLUE CHOICE OF SC