Provider Demographics
NPI:1326087099
Name:KLAUBER, CAROL K (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:K
Last Name:KLAUBER
Suffix:
Gender:F
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:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:3800 FABER PLACE DR
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405
Practice Address - Country:US
Practice Address - Phone:843-747-4647
Practice Address - Fax:843-745-0969
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9342208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC571020809002OtherBCBS SC
SC093428Medicaid
SC571020809034OtherTRICARE SC
SC571020809002OtherBCBS SC
4895Medicare ID - Type Unspecified
SC093428Medicaid